CBT, DBT, ACT, HSE AND

VAGUS NERVE THERAPIES:

 Table of Contents

Chapter 1. COGNITIVE BEHAVIOR THERAPY

INTRODUCTION
CBT is a popular psychotherapy treatment
Common mistakes and myths about CBT
Myths.
Common Errors in CBT
Interventions and Possible Problems in CBT
What is CBT?
Is there evidence for CBT?
How are the CBT sessions conducted?
What could go wrong with this therapy?
CBT- How does this method work?
How do I get screened for cognitive behavior therapy?
What is a typical session like?
On what basis do I decide whether CBT is suitable for me?
Principles and characteristics of CBT
Principles of CBT
CBT Characteristics
CBT interventions
What are Cognitive Behavioral interventions?
What are CBT interventions used for?
Basic CBT framework
Phase one: assessment
Phase two: re-conceptualization
Phase three: skills acquisition
Phase four: skills consolidation and application
Phase five: generalization and maintenance
 Phase six: post-treatment assessment
How to identify emotional triggers
Why emotional triggers occur
How to identify emotional triggers
How to identify your body’s response
How to identify your thoughts
Why CBT works for anxiety
What does CBT do for anxiety?
How can I use CBT to control my anxiety?
Treatments:
Social anxiety and CBT
CBT and Negative Core Beliefs (NCBs)
How to treat depression with CBT
CBT for anger problems
How to overcome negative emotional habits with CBT
How to treat sleep problems with CBT
How to treat panic attacks with CBT
How CBT works for obsessive-compulsive disorder (OCD)
How to treat weight problems with CBT
How to treat bipolar disorder with CBT
How to eliminate procrastination with CBT
How to treat PTSD (post-traumatic stress disorder with CBT)
How to use CBT to overcome Negative Automatic Thoughts (NATs)
How to use CBT to solve common thinking errors
How to treat infertility with CBT
CBT and NLP for treating depression and anxious thinking
Chapter 2. DIALECTICAL BEHAVIOR THERAPY
What is DBT?
 What are the components of DBT?
Types of DBT
DBT vs. CBT
Why Choose DBT over CBT?
Similarities between DBT and CBT
The basics of DBT
How to do DBT
Challenges and Difficulties with DBT
Dialectical stance and strategies
What are dialectical stances?
What are dialectical stances used for?
Dialectical strategies
DBT strategies for an individual session
Characteristics of DBT strategies
How to use DBT to overcome main psychological problems
How to use DBT to treat borderline personality disorder effectively.
Chapter 3. ACCEPTANCE AND COMMITMENT THERAPY
What is ACT?
Basics of ACT
What makes ACT different from CBT
The link between ACT, CBT, and DBT
How to develop willingness and acceptance
How to help patients define their value directions
How to clarify values and commit to valued-based actions
How to be present through mindfulness
How to help clients commit to act by setting goals
How to stop intrusive and obsessive thoughts
How to overcome addiction and substance abuse
 How to understand yourself through ACT
Application and benefits of ACT in everyday life
How ACT can help you overcome rethinking holiday stress
Mindfulness with ACT
How to introduce patients to mindfulness.
Stress management through mindfulness
Chapter 4. HIGHLY SENSITIVE EMPATH
Characteristics of a highly sensitive person
How to be more empathic
The 5 steps of emotional intelligence.
How to find yourself and heal from empathic stereotypes
Strategies to calm your senses and cope with pressure.
How to overcome anxiety and worry and develop social skills when you
are a highly sensitive empath.
How to create a peaceful work environment.
Chapter 5. VAGUS NERVE
Autonomic nervous system.
The brain-body barrier.
The neurology of social engagement
The twelve cranial nerves
What is the vagus nerve?
Historical recognition of vagus nerve.
How to stimulate the vagus nerve.
Functions of the vagus nerve.
Polyvagal theory
What happens if the vagus nerve is damaged?
The autonomic nervous system’s three circuits.
Homeostasis and the autonomic nervous system.
 Five states of the autonomic nervous system.
The three neural pathways of the ANS.
The two-hybrid circuits of ANS.
What is biobehavior?
Effects of activity in the ventral vagus circuit.
Effects of activity in the dorsal vagus circuit.
Somatopsychological problems.
Stress and sympathetic nervous system.
The fight-- or fly reaction.
The polyvagal theory’s healing power.
Stimulation of the vagal nerve-placebo as an alternative cure to
depression.
Benefits of diaphragmatic breathing.
Chapter 6. EXERCISES
Exercise on restoring mutual commitment.
The neurofascial release technique.
The salamander exercises.
Massage for neck tension release.
SCM sore neck exercise.
Twist and turn exercise.
12 vagus nerve stimulation techniques.
Chapter 7. USEFUL TOOLS
Tools that help put the therapies into practice;
Chapter 8. BONUS
How to prevent anxiety, fears, depression, and anger from coming back.
How to overcome fear through self-management techniques.
How to rewire your mind to experience the benefits of a more positive and
emotionally-stable life.
FAQ
CONCLUSION
Chapter 1. COGNITIVE BEHAVIOR THERAPY
 INTRODUCTION
"It is a great life if one can be moderate and content. The wise man has
anticipated the risks; he neither rushes headlong into the thick of the fray
nor turns his back upon it."

-Seneca

Cognitive Behavior Therapy (CBT) is a type of psychotherapy that helps

individuals understand their thoughts, beliefs, and behaviors to try to
change them. It helps people learn how these thought patterns impact their
emotions and how they react to certain events or situations. These skills can
be used to manage stress and depression symptoms. Initially, the client is
taught to identify self-defeating thoughts that lead to negative feelings.
Patients are also taught behavioral techniques such as problem-solving,
goal setting, and relaxation. For example, when someone's anxiety causes
him to fall apart -- the therapist might teach him how to take a deep breath
and count slowly from 1 to 5, then repeat this exercise a few times before
returning to work or school. The goal is for the patient to learn strategies he
can use in daily situations. This intervention could help him become more
aware of his thought processes and, therefore, better able to control or
change them.

"The relationship between thinking (cognition) and behavior represents a

fundamental aspect of human existence. Since the 1960s, there has been a
growing interest in consciousness and cognition related to behavior change.
Cognitive therapy (C.T.) is one of the earliest and most extensively studied
forms of cognitive behavior therapy and aims to use cognition to modify
maladaptive patterns of behaviors associated with emotional distress and
life difficulties."

CBT therapy is usually an individualized approach; each person's situation

is different and thus may require a different type of intervention instead of
using styles or techniques taken from other therapies. CBT is based on the
belief that how we perceive and interpret things, our actions, responses to
events, and interpersonal relationships, can influence how we feel. The CBT
therapist will help the patient examine negative thought patterns to replace
them with more realistic and healthy thoughts.
CBT has been proven more effective than placebos in treating anxiety
disorders and depression. It has also been shown to be an effective
treatment for substance abuse, eating disorders, psychosis, personality
disorders, and even schizophrenia. This type of therapy works best when
the client is highly motivated; these techniques are often difficult to apply
consistently at first – but with practice comes success.

The American Psychological Association (APA) describes Cognitive

Behavioral Therapy (CBT) as short-term psychotherapy supported by
research as an effective treatment for many mental health concerns. CBT is
goal-oriented and focuses on the present while considering past
experiences. Unlike psychoanalysis, which takes place over five to six years
or longer, CBT can last only a few months. People with a past episode of
depression often can benefit from CBT, as it is geared towards treating
immediate situations that might trigger future problems.

"Cognitive-behavioral therapy is a form of psychotherapy (treatment or

cure) that works to change how your mind and body interact to improve
your ability to manage your moods and anxiety." CBT is used in many
hospitals and medical centers throughout the United States and offers
effective treatment for patients with various mental health concerns. CBT
focuses on the present moment and addresses how thoughts are ultimately
processed into behaviors.

Guided by the belief that our thoughts cause our feelings and behaviors --
not external circumstances -- cognitive therapists focus on making patients
aware of these thoughts to change thinking patterns and behaviors. In some
cases, patients are directly asked to challenge their ideas by looking for
evidence that contradicts these thoughts. Patients are encouraged to
become aware of negative self-talk by keeping a daily journal.

The cognitive therapist helps patients examine the relationship between

their thoughts and feelings. For example, suppose a patient believes he is
unpopular because people dislike him. In that case, the therapist may ask
him to take time each day to write down his negative automatic thoughts
about others. The therapist also may have the patient observe his behavior
in social situations, especially when talking with others. The goal is to help
patients understand how their perception of themselves affects their
thoughts and feelings and how those beliefs affect how they react in certain
situations.

Behavior Therapy is "applied behavior analysis," a class of techniques and

principles of learning used to improve human functioning. The methods
derived in large part from the work of B.F. Skinner is heavily used by
behavior analysts as well as other types of therapists (e.g., cognitive
therapists).

In systematic desensitization, a person is exposed to stimuli that provoke

anxiety, usually in a controlled setting. The person is asked to repeat the
desensitizing stimuli repeatedly (think of this as the exposure-response)
until they have become tolerant. If the feared stimulus causes fear and
anxiety, or if the individual finds it too painful or frightening to do this at
home in real life, numerous other techniques can be utilized to learn how to
deal with the fear of such a stimulus (e.g., gradual exposure therapy). Once
someone knows not to be afraid of certain situations (e.g., spiders), they can
move on to confronting the fear in real-life situations.

A significant component of behavior therapy is reinforcement – giving a

child or adult something he wants when he performs a specific action.
Reinforcement is an essential part of achieving any goal. It can be very
effective in modifying behaviors, especially those related to learning
disabilities, mental illness, and addiction (smoking).

Some forms of behavior therapy are conducted by therapists who are not
clinically licensed but receive training. This may be effective in cases where
traditional psychotherapy has failed and patients cannot manage the stress
that leads to addiction, depression, or other mental illnesses. Specific
programs have been effective in treating drug addiction.

A "graded extinction" technique is used when a person fears certain

situations or objects. For example, the therapist may ask the individual to
either approach the feared object or not. Sometimes this can be done
without exposing the person to the actual situation; for example, an
individual may be asked to confront his fears through a program of careful
desensitization. The idea is to teach people not to be afraid of certain
situations and objects; this provides individuals with an experience they can
use in real life as a coping skill (e.g., confronting a fear of heights by
practicing on steps).

Cognitive-behavioral therapy or CBT is one of the licensed professionals'

most common forms of treatment. Cognitive-behavioral therapists believe
that a person's thoughts cause their feelings. By addressing these
cognitions, the therapist can change a person's feelings and behaviors (or
vice versa).

An example is escaping from a situation that triggers negative thoughts,

leaving an inflexible environment, and finding healthier outlets for
emotions. Rather than telling someone to "think positive," they recommend
replacing negative thoughts with positive ones – replacing thinking that "I'm
not good enough" with "I can do this."

Moreover, Cognitive Behavioral Therapy (CBT) is a form of psychotherapy

or "talk therapy" which helps patients understand and change problematic
patterns of thinking, feeling, and behaving. It became one of the most
popular psychotherapeutic treatment methods in the 1970s because it
addresses the cognitive and behavioral aspects of depression, substance
abuse, and other disorders.

Processing, the second of the three main components of CBT, is how

thoughts and feelings are recognized and changed. These cognitions are
then used as a basis for changing behaviors. CBT uses a range of
techniques, including relaxation, and the "ABC" model, such as recognizing
the presence of a consequence and using behaviors to avoid it in the future.
This can be achieved by self-monitoring and evaluating behavior.

Cognitive therapy is primarily used to help people with depression, anxiety,

or related disorders. In some cases, people with severe anxiety may have
nightmares associated with their anxiety that they believe prevent them
from sleeping. Cognitive therapy also helps people work through their
thoughts and feelings regarding a situation or event that has caused them
to become anxious or depressed.

Cognitive therapists help people learn new ways to think about themselves
and their lives concerning the world around them. This allows them to
develop new coping skills to overcome anxiety or depression.
Some cognitive-behavioral therapies have been shown to treat depression,
anxiety disorders, and some eating disorders. Cognitive Behavioral Therapy
(CBT), developed by Aaron T. Beck, focuses on the interaction between
one's thoughts, feelings, and behaviors. Another variant of CBT is Cognitive
Therapy (C.T.), developed by Gerald C. Davison and John M. Neale in the
1970s due to a split between the founders of CBT at Beck's clinic at the
University of Pennsylvania in Philadelphia. C.T. focuses more on the
cognitive aspects of the disorder.

Cognitive behavior therapy is often used with other forms of therapy or

treatment, such as psychodynamic therapy, psychopharmacology,
interpersonal therapy, group therapy, and a host of others. A few people can
be treated successfully with only cognitive-behavioral therapies; however,
such cases are rare. Cognitive-behavioral therapies help people overcome
fears, phobias, depression, delusions, obsessions, and compulsions.
Cognitive behavioral therapy is usually used in conjunction with
psychotherapy. Cognitive-behavioral therapy has been used successfully to
treat people with a debilitating fear of heights and social phobia.

Cognitive behavioral therapy (CBT) is a type of cognitive therapy that

focuses on how people think and how their thinking affects their
feelings/behaviors/actions. This treatment approach also helps individuals
identify, challenge, and change perceptions (the meaning attached to
situations), beliefs (the importance of something in one's life), and urges or
urges to act (e.g., "I could not sleep tonight because I am anxious").

Therefore, CBT is essential since it occurs when a person is consciously

aware of these thoughts, feelings, and urges. This can be in the form of a
conversation between the therapist and the client. A CBT therapist will help
you deal with the stresses that lead to various behaviors. In some cases,
CBT may have been effective because it enables individuals to recognize
that they have control over how they act—not just how they feel—and to use
this knowledge to develop healthy coping strategies.

Cognitive-behavioral therapy treats anxiety disorders, depression, phobias,

and chronic pain effectively. Cognitive-behavioral therapy is a short-term,
goal-oriented psychotherapy treatment that focuses on the here and now.
CBT helps individuals change faulty patterns of thinking or behavior that
have contributed to personal distress or difficulties in interpersonal
relationships. CBT treats many problems, including depression, stress,
anxiety disorders, low self-esteem, marital issues, and anger management.
Cognitive behavioral therapy is effective in treating social phobia and
specific phobias. For example, studies are mixed as to whether cognitive
behavioral therapy works better than exposure alone for social phobia
(social anxiety disorder).
 CBT is a popular psychotherapy treatment
As a popular psychotherapy treatment, CBT has significantly reduced
symptoms of depression, general anxiety disorders, and other mental health
problems.

Cognitive Behavior Therapy is a psychotherapeutic approach as well as a

structured set of techniques in psychotherapy that seeks to identify
cognitive and emotional factors that contribute to distress or disability and
modify these factors with empirically supported therapies (i.e., specific
treatment strategies identified through clinical trials), and promote
behavioral changes that bring about lasting improvement. It should not be
confused with "cognitive therapy," the broader term for rational emotive
behavior therapy (REBT) within the larger group of cognitive behavioral
therapies. The latter is not a therapy that treats mood disorders but is
psychotherapy for treating conditions like depression and anxiety.

Cognitive Behavior Therapy (CBT) is a specific approach to psychotherapy.

It relies on the idea that our thoughts, feelings, and behaviors all interact to
create a feedback loop or "cycle" that can keep us stuck in specific ways of
thinking and behaving. CBT aims to break the cycle by changing faulty
beliefs to more realistic ones, coping skills to help deal with daily stressors,
and behaviors like relaxation techniques or exposure therapy, so we change
our reactions. The goal of CBT is not necessarily "feel good," but more
"function well.

It is nowadays very common since it is a widely known and often applied

form of treatment. Many practitioners offer this technique in different ways,
aiming to reach the same goal: to help individuals with the symptoms of
mental problems. Cognitive behavioral therapy (CBT) is a psychotherapy
that uses behavioral techniques to teach patients to change how they think
and behave. CBT is based on the work of Albert Ellis, who pioneered the
application of cognitive psychology to the treatment of depression.

There are numerous ways for CBT to be delivered, which has led to a
bewildering variety of names and terminologies in widespread media usage.
However, one can identify what should be referred to as CBT as a
structured set of techniques in psychotherapy that seeks to identify
cognitive and emotional factors that contribute to distress or disability,
modify these factors with empirically supported therapies (i.e., specific
treatment strategies identified through clinical trials), and promote
behavioral changes that bring about lasting improvement.

CBT is popular since it is a widely known and often applied form of

treatment. Many practitioners offer this technique in different ways, aiming
to reach the same goal: to help individuals with the symptoms of mental
problems.

Cognitive Behavioral Therapy (CBT) is a psychotherapy modality that uses

behavioral techniques to teach patients to change how they think and
behave. Many therapies use behavior techniques, including "thought
stopping," "cognitive restructuring," "exposure therapy," and "behavioral
rehearsal." It is based on the work of Albert Ellis, who pioneered the
application of cognitive psychology to the treatment of depression.

CBT considers that we have automatic thoughts and emotions that affect
our thinking, feelings, and behavior in several ways. For example, we may
react to a stressful event by having a negative thought like "I am not going
well today," or we may see ourselves as generally incompetent. Hence, a
minor mistake made us feel stressed out and overwhelmed. The goal of CBT
is not necessarily "feel good" but more "function well.

In addition, CBT is commonly used since it is an effective treatment for

many clinical problems, having been validated in more than 400 scientific
studies on its efficacy.

Cognitive Behavioral Therapy is among the most widely used therapies for
various psychological disorders and problems, including depression and
anxiety, anger management issues, eating disorders, trauma, and even
substance abuse.

Cognitive Behavior Therapy has been described as a structured set of

techniques in psychotherapy that uses empirically supported therapies
(specific treatment strategies identified through clinical trials) to promote
behavioral changes that bring about lasting improvement. For CBT to be
effective, the patient mustn't overestimate the effectiveness of the
treatment. The ultimate goal of CBT is not necessarily "feel good," although
it can help you feel better, but more "function well.

CBT techniques can be broadly divided into two categories: (1) cognitive
and (2) behavioral.

- Cognitive techniques alter how a person thinks about an object or event to

influence their emotional reaction. These include reframing, rational
emotive therapy, thought stopping, thought challenging, relaxation training,
and imaging tools (e.g., relaxing images).

- Behavioral techniques aim to alter a person's behavior through

reinforcement or punishment to increase desirable behaviors and reduce
undesirable behaviors. The behavioral component often includes exposure
therapy, systematic desensitization, interoceptive exposure (venturing
within a panic threshold), relaxation training, assertiveness training, and
social skills training.

Cognitive Behavioral Therapy, in the abbreviated form of CBT, consists of a

series of techniques designed to change how a person thinks and behaves.
Similarly to the other therapies, patients are often asked to keep logs and
detailed records for therapists and patients that reveal how much progress
has been made so they can take stock of their progress.

The cognitive behavioral therapy treatment plan outlines how the patient's
emotions and thoughts will differ after each session. The treatment plan is
set out at the beginning of each appointment. Then, the patient is given
several homework assignments between treatment sessions requiring some
thought and effort.

The cognitive behavioral therapy plan is generic and can be used whether
the patient has been referred by their GP or has come directly to the
therapist. Using the SPIKES approach as part of an assessment plan for
depression or anxiety is no longer considered necessary. However, it can
still be used in specific situations to help patients better understand
themselves.

Cognitive Behaviour Therapy (CBT) is a psychotherapy based on cognitive

theories of mind and behavior. It aims to modify distorted thinking patterns
using various techniques developed by Albert Ellis (1913–2007). Ellis
originally called his therapy rational therapy, which became rational
emotive behavior therapy (REBT). Today the term REBT is more often used
for a specific form of CBT that does not include the original psychoanalytic
techniques.

Many health care providers use cognitive behavioral therapy (CBT) as

evidence-based psychotherapy. It holds that distress and impairment result
from the interaction of maladaptive thoughts and behaviors, so they are
best changed through cognitive and behavioral interventions. CBT has been
proven effective in treating depression, anxiety disorders, eating disorders,
addictions, and other problems. Therefore, Cognitive Behavioral Therapy
(CBT) is a psychotherapy based on cognitive theories of mind and behavior.

Benefits that CBT has as a popular psychotherapy treatment

Cognitive Behavioral Therapy (CBT) is a relatively new approach compared

to other psychotherapeutic treatment methods. However, since it has
appeared on the psychological scene for about fifty years, it has
considerably impacted psychotherapy and its usage by different
practitioners. Just like everything else in life, things change, and change is
good. This field of study is one of those that have changed the most
throughout the years. It is still being altered to fit its usability with all age
groups worldwide. To provide appropriate psycho-education, people need to
understand how this relatively new therapy differs from other forms of
treatment like behavior and cognitive therapies.

There are many different areas in which CBT differs from other forms of
psychotherapy. One of the most important attributes involves several skills
and techniques. This approach to therapy does not simply rely on one single
type of therapy for each specific person but rather uses different forms of
treatment for each client; how people view their experiences and thoughts
impacts their life experiences, so it is also necessary to use this as a main
aspect of CBT.

The brain processes information that is received through various senses.

The person's ability to work without difficulty within this system depends on
the mental and physical abilities developed throughout a person's lifetime.
One of the most important factors related to the brain is the consistency of
thought. If thoughts are consistent, individuals can make better decisions
and use their skills more effectively to reach their goals.

A lot of focus is placed on one's thoughts and actions because they are
interconnected. Whether it is a conscious or unconscious process, certain
thoughts manage to stay on your mind even after you have moved on from
the situation. The constant repetition of those thoughts makes them a
significant part of one's life, so they become automatic thoughts. The
individual may not be aware that they can control their thinking process.

Cognitive behavioral therapy has been a well-accepted treatment for the

past fifty years. It has begun gaining research support and acceptance by
society since many studies have been performed confirming its effectiveness
and reliability. However, there are still many questions regarding its
effectiveness and whether it is truly an effective treatment method for
various problems. Since CBT is a relatively new approach alongside
psychoanalytic and dialectical behavior therapy, there are still many
unanswered questions regarding its effectiveness in treating people with
various mental health issues.

Although there are several questions and concerns regarding the

effectiveness of cognitive behavioral therapy, there is still a lot of support
for using this form of treatment. Among the major people who support using
CBT are those who have researched it. They have done a great deal in
studying various aspects related to its effectiveness and reliability. A
significant amount can be discovered due to their experience treating
different types of patients with different mental health problems. Thus, they
have been at the forefront as they contribute extensively to this field by
providing new ways of looking at mental health issues and methods for
treating them.

There are still several questions about the effectiveness of this therapy.
Thus, it is necessary to assist these major concerns to be answered. To
attempt to answer some of the more important concerns, more research
needs to be done. A study will have to be done on people of different ages
and socioeconomic levels to assess their effectiveness with each treatment
method.
There are still many questions about their effectiveness and reliability when
it comes down to treating specific types of mental health problems. This is
because many aspects still need to be investigated, and the results will be
considered valuable information. Thus, more and more research needs to be
done to familiarize people with different issues and their particular
treatment methods.

Despite all the questions about the effectiveness of cognitive behavioral

therapy, there is still a lot of support for its use. For now, this may remain a
popular form of psychotherapy in many mental health clinics worldwide.
However, it will take some time before the support that it has now becomes
sustainable enough for every person who wishes to receive psychotherapy
treatment from undergoing it. For now, it will remain an important part of
psychotherapy.

One of the primary indicators of using cognitive behavioral therapy is that it

has been around for over fifty years. It is one type of treatment that has
gained popularity in the last few decades and continues to be used by many
health professionals to treat different mental health disorders. Although it
has been used for the past several decades, there are still many unanswered
questions about its effectiveness and reliability when treating numerous
conditions that affect people around the globe.

Soon after beginning to use cognitive behavioral therapy, many people have
reported great improvements in their lives and mental health issues. Thus,
there is much resistance to changing this popular form of psychotherapy.
However, there are still concerns about its effectiveness and how effective it
can be when treating certain problems. Thus, more research needs to be
done for the benefits of this approach to be more sustainable and begin to
stand on a more solid foundation.

As mentioned earlier, cognitive behavioral therapy is one of the most

commonly used forms of psychotherapy. There are many reasons why
people choose cognitive behavioral therapy over other types of treatment.
One reason for its popularity may be that it has proven effective and reliable
in helping people with specific mental health disorders such as depression
or anxiety.
Benefits of CBT include:

1. It focuses on the individual's thinking.

By this, CBT focuses on helping each person understand and analyze their
thoughts and behavior. It also helps them reflect on their thinking patterns
and how these thoughts affect the way that they react to situations in which
they are usually triggered.

2. It helps people become aware of the emotions from their own life
experiences.

CBT helps people realize the importance of managing their feelings,

especially when an extreme emotion such as anger is triggered within them.
This form of CBT centers around learning how to recognize and regulate
different types of anxious and mixed feelings that people may experience
during stressful times or whenever a typical negative thought enters their
minds.

3. It helps people learn how to identify negative thought patterns and

cognitive distortions.

CBT helps patients to be able to recognize their negative thoughts as well

as the negative or distorted way, for example, that they interpret their
experiences through visual images, false beliefs, or unreasonable fears and
beliefs.

4. It teaches the most effective ways to communicate with others.

CBT teaches each person how to deal with communication difficulties that
can occur within intimate relationships more effectively by teaching them
how to understand their own emotions instead of reacting based on
situations that seem threatening instead of realistic.

5. It improves people's ability to control their emotions in stressful

circumstances.

CBT helps individuals recognize the difference between an emotion and the
action or behavior motivated by a feeling. For example, helping a person to
understand the difference between feeling angry and acting aggressively
towards others.
6. It teaches each person how to accept constructive feedback from others.

It helps people recognize that as long as they maintain their self-esteem, it

is important for them to be open-minded when receiving advice from loved
ones who wish to help them improve their lives.

7. It helps individuals resolve their problems instead of relying on other

sources of support.

CBT helps each person to identify and resolve their problems instead of
relying on other sources of support such as friends, family members, or
therapists.

8. It increases a healthy lifestyle within each individual.

CBT helps people to do activities that are beneficial to their physical health
and well-being, such as exercise and drinking enough water.

9. It improves interpersonal relationships in each person's life.

CBT helps individuals become more socially competent by engaging in

conversations with others and learning how to communicate effectively with
others in different situations.

10. It helps individuals achieve higher self-esteem through praise or

criticism but their efforts alone.

CBT strengthens self-esteem by helping people recognize how they can

control negative self-talk.

As with any other form of psychotherapy, cognitive behavioral therapy has

pros and cons. Cognitive behavioral therapy may be considered a more
practical treatment because it does not require much time to implement. It
does not require patients to spend extended time in sessions with a
therapist. This may be appealing for some because it does not seem like
such a long process or commitment as other types of psychotherapy may
seem to some people. Another benefit of CBT is that it may be perceived as
more helpful than other forms of psychotherapy because it can help people
with issues such as depression or other mental health disorders. There are
many different types of OCD which include the type that may have begun
after a person was exposed to a traumatic event at an early age. There are
different types of OCD which include OCD related to HIV, sexual
obsessions, scrupulosity, and contamination. Therefore, CBT may be more
effective as a treatment for these conditions because it helps people to focus
on counteracting their negative thoughts instead of avoiding the situations
that trigger them. As a result, CBT works well with highly structured forms
of therapy, such as exposure-based therapies.

Finally, another positive aspect of CBT is that therapists and patients can
focus less on past experiences than on the present when working together.
This form of therapy has the potential to be successful because it helps
individuals to recognize how certain triggers influence their current moods
or behaviors in their lives. Therefore, they can more easily focus on the
present situations they encounter throughout their lives versus dwelling on
the past.

11. It helps the person understand and to accept the severity of the
condition or problem.

CBT can help individuals accept that they have a mental health problem or
illness that may not have been caused by any form of trauma in their life. It
can help them understand that there is no need to feel guilty due to their
condition because it is not something they brought upon themselves. They
may also learn how to deal with new situations that trigger an extreme
emotion within them, such as anger, through CBT and learn how to avoid
negative thinking patterns. This form of therapy explains how proper
treatment for OCD will benefit them in the long run.

12. It teaches the patient to be more assertive and not introverted.

CBT can teach the patient what they can say to themselves before they
speak when they feel uncomfortable in situations to be assertive. CBT can
help the patient learn to recognize what is bothering them and avoid
negative or extreme thoughts that may interfere with their life. For
example, a person with a social anxiety disorder needs to understand that
they worry needlessly about negative thoughts that tend to ruin their self-
esteem. With CBT, therapists will try different ways. Hence, patients
understand why it is helpful for them to communicate with others instead of
being quiet in an attempt to avoid rejection or harsh criticism from others.
13. It helps the patient understand and modify unwanted behaviors.

CBT can help the patient learn how to identify what inappropriate thoughts
are causing them to become anxious in certain situations. CBT gives them
more information on identifying their unusual thoughts and how they can
use it to help them avoid excessive worry about those negative thoughts.

14. It helps the patient learn how to manage stress and anxiety by learning
that it is manageable with proper treatment.

The goal of CBT is for the person to be able to recognize when they become
overly anxious or stressed, which is an underlying symptom of OCD, and
work towards learning new strategies to cope with their adverse reactions
to specific situations that trigger their extreme negative emotions. This
form of therapy benefits the patient because it may alleviate their stress and
anxiety. After all, they know they can rely on other forms of treatment to get
better. If a person continues to engage in positive activities, they are more
likely to be successful in managing their stress or anxiety as a result.

15. It helps individuals understand how thoughts influence emotions to alter

them accordingly.

CBT enables the patient to become aware of how their feelings can be
changed or influenced by certain events or thoughts. They can learn to
recognize inappropriate thoughts that may negatively influence their
emotions and change them immediately. CBT can help the patient to
recognize which situations may make them angry or embarrassed because
of their OCD. They can also learn how to use CBT techniques to minimize
their negative feelings when triggered by certain situations that previously
caused extreme emotion.

Many factors contribute to CBT's success as a form of psychotherapy.

Through understanding the benefits, drawbacks, and possible ways that
CBT helps people, clients may receive better results through this treatment
instead of other forms of therapy. Suppose a person is struggling with OCD
and may be at a socioeconomic disadvantage due to their finances. In that
case, it may be difficult for them to receive treatment through Medicare.
Therefore, patients need to recognize CBT's options and advantages over
other forms of therapy, such as medication. Hopefully, this report can help
individuals learn why CBT is a distinctive form of therapy that has helped
people overcome many severe mental health disorders.

On the other hand, CBT is not always a perfect form of therapy. It may not
be suitable for all people due to its inability to address the core motivations
of particular beliefs and negative emotions. In some instances, careful
analysis of core beliefs and how negative thinking patterns maintain them
can help people achieve a better quality of life by assisting them in making
more positive thinking choices. As previously mentioned, cognitive
behavioral therapy does not address these core issues. In other words, it
does not focus directly on identifying the most important factors influencing
thoughts and actions. For example, a significant reason why some people
struggle with their OCD is due to their irrational beliefs. This type of
therapy does not necessarily address or modify these issues as effectively as
CBT, so it may be necessary to engage an individual in other types of
therapy, such as acceptance and commitment therapy.

Although recent research is sparse and not always methodologically sound,

cognitive behavioral therapy has been widely studied. The effectiveness of
CBT in treating anxiety disorders is supported by several randomized
clinical trials, with the effect size being moderate to large and clinically
significant. In general, the studies show that CBT increases anxiety disorder
symptom reduction (that is, in general, decreases the amount of time that
patients have severe anxiety). This effect has been found to persist for up to
two years after treatment. Note that a similar effect has been found for
medicated patients as well.

In addition, CBT is associated with lower relapse rates and recovery rates
than other therapeutic approaches. For example, one study found that CBT
was more effective for treatment-resistant depression than cognitive
therapy or a combination of both.

However, several meta-analyses have suggested that there may be a point

at which therapy stops working. Some meta-analyses, for example, suggest
that the effect size of CBT decreases after six to eight months of treatment.

Therefore, there is a suggestion that further improvement may be small and

not clinically significant. This is in line with findings that show a dose-
response relationship between exposure and response to therapy, which has
been observed mostly in studies with people who have not had previous
exposure to CBT.

Another limitation of the research is that it primarily focuses on depression

and anxiety disorders. Therefore, it is unclear how useful CBT would be for
other diagnoses, such as specific phobias and eating disorders.

However, studies have shown that CBT is effective for OCD and social
anxiety disorder, which have unique diagnoses. While more research is
needed to understand the effectiveness of CBT for these diagnoses, it is
clear that further research can help us to determine when further
improvement has stopped and when further improvement may be achieved.
A promising practice for understanding the effect of therapy on depression
and anxiety disorders is propensity-score matching.

This approach performs a statistical analysis such that patients are assigned
to the treatment groups at each baseline visit based on their smoking status
(cognitive behavior model or active control) or their propensity score (CBT
or active control). These methods allow for an unbiased comparison of the
effect size between the active treatment (CBT) and the control condition
and provide a much more accurate estimate of real-world effectiveness than
a simple analysis of whether or not treatment was more effective than
control. In addition, this matching technique allows for an unbiased
estimate of how many patients would respond to a specific intervention. For
example, it is unknown how many people who suffer from depression will
benefit from CBT. The propensity score matching allows researchers to
determine who is likely to benefit and then assign them to either CBT or
inactive control conditions. The results show that when tending to
depressed patients, 19–40% of people may benefit from CBT based on their
propensity score.

This is a much more accurate estimate of the potential success of CBT in

comparison to the previous studies, which looked at those who had already
received treatment. In addition, while it may be true that CBT does not
work for everyone, it can help millions of people worldwide due to its
effectiveness and practicality.
Although CBT is a highly effective treatment for depression and anxiety
disorders, it is important that, as a society, we recognize that CBT is not
always the most effective approach to mental health disorders. As
mentioned, this report heeds this fact to help individuals and other key
stakeholders understand why CBT is easily the most effective approach for
many people who suffer from anxiety and depression disorders.

Cognitive behavioral therapy is one of the most effective treatments in

helping patients suffering from severe anxiety disorders such as generalized
anxiety disorder, social phobia, panic disorder, post-traumatic stress
disorder (PTSD), OCD, and depression.

CBT is used to treat psychotherapy since:

1. Clinically useful and well-established.

CBT is useful for adult patients who are suffering from severe anxiety
disorders.

For this reason, CBT is used for the treatment of anxiety disorders and
disorders related to learning disabilities which include:

• Attention Deficit Hyperactivity Disorder (ADHD)

• Autism spectrum disorder (ASD)

• Dyslexia

• Learning difficulties

• Mood Disorders such as Depression, Bipolar, and Severe Depression.

CBT has also been effective for anxiety disorders such as post-traumatic
stress disorder, generalized anxiety disorder, panic attacks, phobias,
obsessive-compulsive disorder, and night-time insomnia.

2. CBT has a high success rate.

The success rate of CBT ranges from 40-80% when treating anxiety
disorders (this is the same success rate as medications).

There are different approaches in cognitive behavioral therapy based on the

patient's clinical needs. Therefore, there are many variations in procedures
and techniques used by therapists to treat anxiety disorders based on their
needs.

This way, cognitive behavioral therapy is not just one treatment but can be
tailored to suit each patient's needs. It can be an effective approach to
mental health care for patients suffering from severe anxiety disorder and
depression problems.

3. It’s more cost-effective than other therapies.

The cost of CBT is much cheaper than other therapies used to treat severe
anxiety disorders.

Because of this, it is highly recommended that people in psychotherapy

consider using CBT if they can afford it, as it will prove to be more effective
and cost-efficient.

4. Proven in helping patients who have not received treatment before.

CBT is effective for anxiety disorders such as post-traumatic stress disorder,

generalized anxiety disorder, panic attacks, phobias, obsessive-compulsive
disorder, and night-time insomnia.

This means that people who have not previously sought treatment for their
mental illness problems can benefit from CBT due to its high success rate
when treating severe anxiety disorders.

5. It can be used to treat depression and anxiety disorders in collaboration

with medication.

Sometimes, therapy and medication may not be enough to treat severe

anxiety disorders. Also, many people do not want to take any medications,
as they may become dependent on them or do not think they will work
effectively.

CBT, when used alongside medication, can help people suffering from
severe anxiety disorders maintain their quality of life and gain a more
positive outlook on the future.

6. CBT is used on a wide spectrum of ages.

In cognitive behavioral therapy, the therapist will choose the most
appropriate treatment for an individual based on their age and childhood
experiences.

This means that CBT can be effectively used with adults, children, and
adolescents suffering from severe anxiety disorders.

CBT treats anxiety disorders in children and adolescents because the

techniques are consistent with cognitive development (children learn by
doing). Therefore, when a child is taught these techniques, it helps them
learn how to cope with demanding situations in their everyday lives.

7. It’s beneficial if you feel that you don’t want to treat your anxiety
symptoms with medication but still want to make some changes in your life.

CBT can be beneficial if you do not want to take medication; however, you
still want to make changes to live a happier, healthier, and more fulfilling
life.

Because CBT teaches new coping skills, it is a good approach to mental

health care for patients suffering from severe anxiety disorders who do not
wish to take medications.

8. It's focused on the here and now instead of dwelling on past events.

The primary focus of CBT is on the patient’s current problems and how they
can deal with them in their everyday lives.

This means that CBT does not focus on negative memories or events from
the past that have contributed to the development of a mental illness.

This helps an individual keep the focus on their life today.

CBT is effective when treating a wide range of mental health disorders

because it helps people to view their lives more positively and take things
one step at a time.

9. It takes into consideration the mind-body connection.

Cognitive behavioral therapy uses cognitive techniques that allow people

suffering from anxiety disorders to think about and change their thoughts,
feelings, and behaviors. This can include changing how they think about
themselves, other people, and their surroundings, and how they act on
these thoughts and feelings.

This makes cognitive behavioral therapy a good approach to mental health

care for patients suffering from anxiety disorders as it focuses on changes
in the mind, body, and environment.

10. It helps people to have a more meaningful and productive life.

CBT teaches people how to change their thinking, feeling, and acting to use
these skills differently and live a more fulfilling life. Doing this regularly
helps people who suffer from severe anxiety disorders gain a better quality
of life.

11. It improves relationships, making them stronger.

In cognitive behavioral therapy, the therapist may ask for assistance from
family members or friends to help the patient change their behaviors. This
can include being more supportive and encouraging and helping them
refocus their thoughts and feelings on positive aspects of life.

This is because CBT is focused on improving relationships with others

through communication and support. Therefore, it is a good approach to
mental health care for patients suffering from severe anxiety disorders as it
can improve their relationships with others.

12. It teaches you solution-based techniques that you have learned over
time so that they become second nature.

Cognitive behavioral therapy enables you to make changes in your life using
problem-solving techniques taught by the therapist.

These techniques should be used in everyday life to help you cope with
situations that may trigger feelings of fear or panic at first. However, over
time these techniques will become second nature, and you will use them
automatically when faced with difficult situations.

Cognitive behavioral therapy is one of the most effective approaches to

mental health care for patients suffering from anxiety disorders. With
research demonstrating that CBT can be used to treat a range of mental
health disorders successfully, it has become one of the most recommended
forms of therapy for treating severe anxiety disorders. Research has also
shown that people who completed CBT have reduced their anxiety levels
after treatment.

Research has shown that CBT can be used to treat patients suffering from
severe anxiety disorders who use medications because of varying levels of
improvement. Therefore, it is a good approach to mental health care for
patients suffering from severe anxiety disorders.

The primary benefit of CBT is the ability to customize and tailor treatment
plans for individuals based on their personality, behavior, and cognitive
functioning. Cognitive behavioral therapy can be effective for patients who
may not respond well to medication.

CBT is effective in treating many different anxiety disorders. This means it

is a good approach to mental health care for patients suffering from specific
anxiety disorders, as it can effectively treat them. If a patient has more
than one type of anxiety disorder, it may be most beneficial to have several
therapists working together on their care plan.

Therefore, Cognitive behavioral therapy can help people who suffer from
anxiety disorders understand the course of their disorder and find ways to
cope with their symptoms, allowing them to lead happier and healthier
lives. CBT is a cost-effective therapy for patients suffering from anxiety
disorders, with research showing that it does not cost a lot of money and
can be easily accessed. This means that cognitive behavioral therapy can
significantly affect the quality of life of people suffering from anxiety
disorders.
 Common mistakes and myths about CBT
Cognitive Behavioral Therapy (CBT) is the most commonly used form of
therapy for a wide range of mental health problems. But CBT only works if
it is done right; unfortunately, many therapists don't understand how to
provide evidence-based, successful CBT. This book post will address some
common mistakes and myths in CBT and help you avoid them.

Many believe CBT involves talking about thoughts, using thought records,
analyzing negative thoughts, filling out mood charts, etc. This attention to
thoughts is particularly important if you suffer from depression, anxiety, or
obsession problems. However, if the main problem is things like anger
outbursts or substance use, the thoughts are less important, and focusing
on changing behavior is more effective. Similarly, the behaviors are most
important if you have relationship problems, not your thoughts.

But this doesn't mean that CBT doesn't help you explore and challenge your
thoughts on other types of problems. The effectiveness of CBT depends
more on how well it addresses behavior than how much time it spends on
analyzing thoughts.

There are several mistakes regarding CBT. These include:

1. Being too general or focusing too much on the negative.

This is common in clinical practice. People get referred for a specific

problem – for example, a woman who has panic attacks when she rides an
escalator at the train station. She comes to you because she wants help with
her problem with this one situation.

But then you ignore that and say something like: "The anxiety is caused by
your pessimistic expectations of what might go wrong. Let's focus on that".

This general focus seems to make sense, but it can end up ignoring the very
problem people thought they were coming to treatment for. This can lead to
poorer outcomes.

Secondly, it is easy to get stuck focusing on problems in the past and get
stuck in a type of negative rumination which can make things worse. In
CBT, we want to focus on what we can do today – and this means that our
main emphasis is on planning positive changes for today, tomorrow, and the
near future.

This often requires special training for therapists because it means you
must interrupt your thinking about the past or worries about the future and
concentrate on what's important now.

2. Focusing too much on cognitive issues when behavior change is key.

This is common in clinical practice as well. One of the main differences

between CBT and other types of therapy for many problems is that CBT
focuses more on behavior rather than thoughts or emotions. After all,
thoughts and emotions are a normal part of daily life, but how we behave
can affect our thinking, moods, and ability to cope with everyday problems.

For example, when you don't call someone back for a date, you might panic
about your lack of confidence. If you feel more confident, you might call
them back and make a date. So there's a clear link between your behavior
(not calling them back) and how you feel (anxious).

This doesn't mean we don't learn how to challenge our negative thoughts.
But we do it to change our behavior and not because we think it will make
us feel better!

3. Focusing on negative emotions or thinking styles.

This is common in clinical practice. It's useful to understand what makes

people feel anxious, sad, or depressed because these feelings often become
targeted by clients themselves who want to change their feelings with the
hope that they will then get rid of the problem. But the problem is that
emotions don't have to be something we want to change – they can also be
part of a coping mechanism. We might feel anxious because we are worried
about something that has happened in the past. But as a coping mechanism,
anxiety can help us stay vigilant and cautious or help us deal with or
recover from a difficult event.

For example, you might feel anxious when a friend leaves early on a night
out. But this could be useful if you want to avoid making the same error! We
often overlook the positive aspects of emotions when trying to change them
for good.
4. Focusing on thoughts and ruminating about the past or the future.

This often happens in clinical practice, especially if clients don't know what
to do with their thoughts or feelings. For example, suppose you are in an
argument with someone and get angry and defensive. That can be useful
because it helps you feel more ready to handle the situation and develop
your arguments so they stick. But if you keep rambling back and forth
thinking about what your friend has said, this can make matters worse and
make both parties angry without any solution being reached.

5. Focusing on the goal rather than the process of change.

This is a common mistake in mindfulness-based approaches to

CBT. Mindfulness is often said to be a way to achieve non-judgmental
awareness. But this doesn't mean you can use it to forget why you want to
change in the first place. You still need those reasons – they are your goals –
and whether or not you achieve them will depend on whether or not you
have made changes along the way!

This is why it's important to find out what you want and develop goals based
on your values, not just on what seems achievable alone. This also means
you can focus on the change process and not just the goal. You might not
achieve your goal – but you can still feel good about the fact that you have
tried and learned something about yourself or how to achieve what you
want in the future.

6. Focusing more on symptom reduction than personal growth

This is common in clinical practice because of its origins in behavior

therapy. CBT was originally developed to treat mental health problems as if
they were like physical diseases (where treatment should reduce
symptoms). But CBT is not just about reducing symptoms; it's about
teaching skills that can help you cope with problems and feel more able to
respond positively to the obstacles we all face.

For example, we learn that sticking to your goals and not changing them
just because of a setback will make you feel more confident as time goes on.
But your sense of self can disappear if you just focus on symptom reduction
– like trying to avoid feeling anxious or depressed. Feeling bad can be
difficult to be strong because the problem will make you want to give up!

There are many other mistakes therapists can make when they fall back on
behaviorism rather than embracing some of the key elements of
psychotherapy. In clinical practice, it's often difficult to get therapists to see
beyond their old habits and techniques. But the most important thing is to
remember that we have choices – we can choose where to focus our
attention and what skills we will learn.

For example, clinicians often unconsciously assume that clients know the
best way to solve problems. When clients come in for CBT – or counseling in
general – they tell us they want help with a problem (a symptom). We
respond with advice on how we think they should solve the problem or what
might be possible future solutions. But clients often end up feeling
frustrated that the new problem on the table has been solved without
asking them what they want or how they want to solve it.

You can see the relationship between symptoms and goals by looking at
your board in mindfulness-based CBT as you walk past it. When you get a
symptom, look at your goal and ask yourself: "Is this symptom helping me
move closer to my goal?" If it is, then keep focusing on that symptom. But if
not, look for something else on your board that might help you achieve your
goal.

You can use pen and paper if you don't have a board in your office or home.
And you can use any method that helps you move beyond just identifying
symptoms and being trapped in a circular problem-solving process. The
most important thing is to create something that helps you to focus on the
present moment and find out what you want from your board and therapy.

7. Focusing on the past, present, or future alone

Mindfulness-based therapies are turning a lot of attention to the importance

of being here and now. Awareness is helpful for many problems, but it can
get in the way if we focus only on the past or just on what's going to happen
in the future. To create a mindfulness therapy that works, we have to bring
mindfulness into awareness everyday and make it our main focus when
doing something unrelated to awareness.
For example, I often find that clients who aren't close to their goals will try
too hard when they start the CBT process – focusing on how good they feel
about their progress so far. But they can deny that they are not yet where
they want to be. They may only think about what they need to do in the
future rather than focusing on what's possible.

For these clients, it's much better to focus on the present moment and
realize how unlikely everything will go perfectly as planned in therapy – or
out in the real world! It's much more useful to find out what you have
achieved and understand why you weren't able to succeed yet – as all
people fail at some stage.

How to prevent these mistakes regarding CBT:

1. Focus on awareness and the present moment

Find out what you want in life. This begins with your board and then the
process of setting goals. Don't stick to just one goal at a time, but try to
think about how you can achieve multiple goals in your life. Don't just focus
on what you have achieved so far, but look for things that have gone wrong
or that you weren't able to do yet. Use setbacks as learning opportunities
rather than seeing them as failures. Think about what you want to achieve
in the future and use the goal-setting process to get your focus on that right
now.

2. Cooperate with change, not just symptom reduction

For example, you might choose to start your therapy by focusing on changes
in your thinking and behavior (syndrome reduction). But this is only part of
the story because there needs to be a balance between personal growth and
getting control over your symptoms. If you focus 100% on symptom
reduction for too long, this can become an avoidance strategy, which may
cause anxiety that will prevent personal growth.

3. Don't be afraid of setbacks

Setbacks are inevitable, and it's much better to learn to use them as an
opportunity for improvement instead of getting rid of every possible setback
as soon as possible. When you realize that setbacks are an essential part of
the process, you can make the most of them – even if they have been
difficult.

4. Avoid blame and shame

People can be afraid of blaming themselves or others when things go

wrong, but this often means we blame ourselves more than necessary!
When we take a balanced approach, we will be more likely to forgive others
(or ourselves) when things don't go exactly as planned in therapy.

5. Avoid the power of self-blame

Many people have been taught to blame themselves for what has gone
wrong in their lives. Therapy can be a place to discover your limitations and
other people's limitations! But this is only part of the story – instead, we
have to look at things from an objective perspective. This is only possible if
you accept that no matter how well things go, someone else may still be
able to do a better job within their limits than you can!

6. Face your fears and accept your vulnerabilities

For therapy to be beneficial, you have to be able to face up to your fears.

CBT is about vulnerability, and you must be willing to use this as a learning
process. If you feel uncomfortable with counseling or other therapies, you
will probably shy away from them.

7. Be empathetic – not judgmental

This can create conflict if you try to get others to understand how you feel
and why you do things. It's much better for everyone involved in CBT to be
able to empathize with each other so that we are all working together as a
team to understand how things go wrong.

8. Learn from mistakes made by others

As the saying goes, it's always best to learn from someone else's mistakes –
even though this can be very difficult! If you make a mistake, learn from it,
and don't let it stop you from learning.

If you have been struggling with your therapy and finding it difficult to
connect with your therapist, it may be time to take stock. But don't worry –
remember that all people struggle when they try to make changes, as CBT
can be confusing at times!

But there are some things that you can do to minimize the risk of getting
stuck in therapy:

a. Don't just focus on your thoughts and feelings

If you spend a lot of time working on the content of your thoughts (theory or
hypothesis) and how you feel about them (emotions), this might lead to
problems in therapy. You should also consider what happens next
afterthought or feeling. For example, you might work on a thought for a
while, and you become aware that a certain situation seems to make you
sad. Then you might choose to do something about it or not. Your reaction
to the situation will tell your therapist what is needed in therapy then.

b. Don't avoid thinking about personal problems

If we cannot admit that we have personal problems, it may be more difficult

for us to make changes in therapy.

c. Face your fears and accept weaknesses

If you cannot face up to your fears, you may never be able to make changes
in therapy. Anyone afraid of making changes will not be able to succeed in
therapy.

d. Get support from family members or friends

If you cannot get out of a situation that seems stuck with someone close to
you, it may be time for further help – and this could mean therapy! Personal
growth is often easier with another person involved in the process.

e. Admit that you are not Superman or Superwoman

You may need to hold things together all by yourself, which can be
exhausting! When you admit your limitations and ask for help, then you will
be able to find the right therapist who can help you.

f. Don't be afraid to get support from a therapist-in-training or trainee

psychologist
When finding a suitable therapist, remember that not all therapists are the
same. If someone has just started their journey of becoming a therapist,
they can still learn along the way! If unsure whether they have the
experience and skill required for CBT, ask them about it and say if you think
they are not up to scratch. Most therapists-in-training will be glad to hear
your feedback and try to get more experience if possible.

g. Don't give up too easily

Quitting can become a habit, and you may find it difficult to stop doing it
even when it is not in your best interests! As with most other things in life,
perseverance can be challenging but also rewarding. If you feel like giving
up, just remind yourself that CBT is only one part of the bigger picture –
and in the long term, there are much better things ahead for you!

h. Face your fears instead of trying to avoid them

When you try to avoid something that makes you anxious, then this can
cause problems in therapy. You may avoid it because you feel that it is too
difficult. But the more difficult tasks are often the ones that can bring us
closer to the things we desire in life. When you face your fears, you can
start to make progress, which is one of the therapy's most important
components.

i. Accept your weaknesses as part of life

We have all been taught that we need to be perfect – but this is often
impossible! If something doesn't work out for us in life, we think there must
be something wrong with us – when actually, it might be a small obstacle or
setback rather than a huge problem!

j. Learn from the mistakes of others

Someone will make a mistake when you try to change things around you.
This is a very important aspect of counseling and other therapies – the more
mistakes we make in therapy, the better we learn! If you want to continue
in therapy, you need to be receptive to other people's experiences – but this
may not always be easy!

k. Don't compare yourself with others

If you compare yourself with others or strive for perfection, then this can
cause problems. You may feel that you are not good enough or that your
problems are worse than other people's. Remember that everyone is
different, and some people have different experiences of problems and can
face them in different ways.

Therefore, mistakes experienced in CBT must be prevented since they may

lead to a possible dropout of therapy. This involves a therapist that can
understand their client's problems and needs, we are usually assigned a
new therapist, or there might be some other issues that can affect whether
we stay in therapy or not.

Some issues that can prevent a client from staying in therapy include:

A therapist is unable to understand what's going on around the individual.

A therapist who cannot offer sufficient support to the client.

A therapist is not going to accept a person's problems as well as their

progress in therapy.

A therapist who does not have enough motivation and willingness to help
individuals with their problems. A depressed, anxious, or stressed client
may feel like there are no possibilities for improvement and may not
complete the CBT treatment for longer than intended sessions or
completely drop out of the course.

Myths.
a. CBT therapy is just for people with anxiety or depression.

CBT can be used to help a range of mental health problems. It's widely
known as the 'gold standard for treating these conditions and other
psychological disorders such as OCD and eating disorders.

b. CBT is used with only specific mental health issues- like OCD and
depression

CBT has been used successfully with a multitude of different disorders,

including addiction and even ADHD! One common misconception is that
CBT involves changing your thoughts to "cure" the problem - but this isn't
true. The idea behind cognitive behavioral therapy is that by identifying
negative thought patterns which lead to negative emotions (e.g., stress,
anxiety, depression) and changing the patterns which cause the negative
emotions, you can then change the negative emotions. The idea is that you
will have positive emotions once you have positive thoughts.

c. CBT requires you to spend a lot of time thinking about your problems

On the contrary, clients are encouraged to think as little as possible about

their negative emotions or the unwanted thought patterns they experience
when doing CBT. When people want to discuss their problems at length -
something they often do without knowing - it's usually because they are
trying to figure out how they 'should' be feeling in a situation and why
things aren't going their way. In CBT, this is not necessary and can even be
counterproductive. The focus is on the here-and-now, not what happened in
the past or what might happen in the future.

d. CBT requires you to challenge every single thought or emotion

Again, quite the opposite is true! Cognitive behavioral therapy aims to learn
to identify and change only the thoughts causing you problems - those that
are negative or unhelpful. You don't want to waste your time challenging
each thought you experience as it happens. The idea is to learn to identify
your thoughts and then change them so your emotions improve.

"CBT (Cognitive Behavioral Therapy) is a way of learning to be aware of,

understand and change the thoughts that cause problems in our lives."

For more information or if you are interested in getting help for issues
mentioned above or something else related, read some of my other posts
about depression and anxiety treatment.

e. CBT is only used with people who are very depressed or anxious

CBT effectively treats people with severe mental health problems such as
depression, anxiety, schizophrenia, and obsessive-compulsive disorder. It
can also help people with self-esteem problems, anger, or other issues.

f. CBT involves meeting with a therapist once a week.

CBT usually involves meeting with your therapist once or twice weekly for
about 12 weeks, but it can be longer if necessary. If you are doing CBT
online, the number of sessions will vary depending on your therapist's
advice and how much you need to work on specific issues.

g. CBT involves lots of talking and thinking to "work out" your problems.

CBT is often understood as 'talking therapy' because talking about the past
and thinking about what made the situation worse can be very useful when
looking at ways to change it or prevent it from happening again. But not
everyone needs to talk about their problems, and many people are happy
with just seeing their therapist once or twice a week to discuss areas they
feel they need help with.

h. CBT involves challenging your thoughts and changing them.

CBT may involve challenging your thoughts if they are unhelpful, but it also
involves accepting your thoughts as they are. For example, if you're feeling
sad about something which has happened in the past, it will be normal to
think about this situation and feel sad for a few days. But what needs to be
changed is how long you stay stuck feeling sad, not how often you think
about the situation or how intense the sadness feels.

i. CBT doesn't work for everyone

The majority of research shows that CBT is an extremely effective treatment

for people with anxiety problems (e.g., panic disorder, phobias, post-
traumatic stress disorder), depression (e.g., severe depression, dysthymia,
bipolar disorder), and eating disorders (e.g., bulimia nervosa, anorexia
nervosa). CBT can also help people who have problems with self-esteem or
anger.

j. CBT is expensive

Depending on your area of the world and what type of therapy you opt for,
the cost may vary slightly - but it is generally relatively inexpensive. The
cost of CBT can also be paid in installments to ensure that people who need
help can afford it in a way that suits them best.

These myths must be avoided since they could potentially demotivate or

discourage someone who feels they need help. CBT can change people's
lives and yours, too, if you're willing to put a little time into it. Moreover,
CBT is an excellent way to treat yourself if you feel you have a problem that
needs help. If you're unsure whether CBT is right for you, one of the best
things you can do is contact your therapist and ask them what they think!
They can tell you exactly what they think CBT can do for you and how much
it will cost.

Common Errors in CBT

When talking about CBT, it can be easy to get confused and make a few
errors in our thinking. These are some of the most common errors that
people make and how you can avoid them:

1. Believing that any thoughts or emotions are 'bad' in some way

Many people believe that their thoughts or emotions are somehow 'wrong'
or bad for them - even if there is no proof for this being true. This can send
negative messages to yourself and lead to more problems due to your
beliefs about what is happening in your life.

2. Believing we should be able to 'think positively' no matter what

If we try to avoid negative thoughts or block them out, this can mean that
we don't work through problems and fix them in the long run. Some people
try to be positive, but this rarely helps them in the long run. Instead of
avoiding negative thoughts or emotions, it is better to learn how to accept
these as a normal part of being human and then challenge them when they
are unhelpful.

3. Trying to think positively without accepting negative thoughts and

emotions

If we only accept positive things about ourselves, people, and life in general,
then we are unlikely to experience real happiness at any time. Thinking
positively is a skill that takes time to build up in the long run. Once we have
learned to think positively, we will know that it is okay to have negative
thoughts and emotions - but they do not determine who we are. We don't
have to let them rule our lives, as this is what unhelpful thoughts can do in
the long run.
4. Blocking out negative feelings and thinking about all the 'good' things in
life

If we try to avoid our negative thoughts or block them out, some of these
emotions can't be worked through and don't get dealt with properly. So if
we think about our problems and deal with them, negative thoughts or
emotions don't determine our whole life.

5. Blaming ourselves for feeling 'bad' or unable to think positively

It is important to remember that thoughts and emotions are not 'bad' or

wrong. For example, if we think negatively about something and react
badly. As a result, this is not because we're bad people; we have unhelpful
thoughts that need to be changed. If we blame ourselves for not being able
to think more positively, it may mean that we don't take responsibility for
what happens to us in the long run.

6. Thinking that CBT is a 'one size fits all approach to life

CBT is used for many problems and situations but requires time and effort
to work properly; it cannot be done for you. Everyone has their ways of
thinking about things, so the way you interpret therapy may not be the
same as someone else. But this can also mean that what works for you could
be different from someone else's experience.

7. Expecting CBT to be a 'quick fix' approach

CBT is often used as a quick fix in the media and TV. But the reality is that
it takes time, effort, and commitment to work through the problems you
have. However, the result is that life can become better and more enjoyable
when you try to learn how to think differently.

8. Only trying CBT once or twice

Unfortunately, many people give up on therapy too early without giving it

enough time and effort to work. Many people go through months of therapy
before they start getting better, so you should give CBT plenty of time
before making a final decision about whether it helps your problems.

Interventions and Possible Problems in CBT

While CBT is generally a very effective treatment that can help various
problems and situations, it still requires you to play an active role in your
therapy. Moreover, it may take a while before you start to feel better if
you've struggled with depression or anxiety for quite some time. Here are
some of the possible interventions you can expect and how CBT can help:

1. Identifying problem thoughts in CBT

The first step in CBT is to learn to identify problem thinking patterns that
lead to negative emotions or destructive behaviors. This helps people to
understand that they can change their way of thinking and even how they
react to certain things in life. If a problem occurs, we don't have to accept it
as 'bad' or unchangeable; we just need to work through these problems so
they don't run our lives anymore.

2. Challenging problem thoughts in CBT

Learning to challenge these beliefs in therapy is crucial, as full acceptance

of negative thoughts only leads to more problems in the long run. The goal
is not to ignore or push away negative thoughts but to learn how to examine
them and challenge them directly, so they don't determine our experiences.
Some people may teach themselves until they fully accept their negative
thoughts, and then it can become easier for them to deal with other areas of
life.

3. Identifying personal and social triggers in CBT

If you know why you have certain problems, you can then work on things
that may trigger your disorder, so the triggers do not cause problems in the
long run. For example, if you have panic attacks in public places but only
around your boss, you can find ways to manage your stress at work and
avoid things that might lead to a panic attack. Learning to identify things
that may trigger your disorders is important to avoid them or manage them
better.

4. Challenging personal and social beliefs in CBT

Many people believe certain things about themselves which are inaccurate
and lead to more problems in the long run - this is known as self-talk. For
example, suppose someone believes they're stupid for making mistakes on
the job or incapable of relating to others. In that case, this can lead to a
downward spiral of negative thoughts and cause even more difficulties in
their lives. It becomes easier to manage our experiences if we can challenge
these beliefs.

5. Focusing on positive or realistic goals in CBT

Focusing on what you want to achieve in life can help us to overcome

problems such as depression and anxiety. For example, if someone has
negative thoughts about not being good enough at something, it may lead to
a lot of stress and unhappiness that does not resolve after a few weeks of
therapy. The goal of CBT is not to completely change the way you view
yourself but rather to focus on realistic goals that don't make you feel like a
failure - such as improving your performance in certain areas or learning
certain skills that are helpful in the long run.

6. Developing coping skills in CBT

One of the most important aspects of CBT is learning how to manage your
emotions and cope with life's challenges when you have serious problems.
This is called emotion regulation. For example, someone who is depressed
may have unrealistic thoughts about their worth that sometimes make them
feel depressed or worthless. They may also have anger directed at others
when they think about problems in their lives. By learning skills for
regulating emotions and improving coping strategies, we can focus on other
parts of life and lead a better existence.

7. Improving social skills in CBT

Many people with depression, anxiety, or other problems have trouble

relating to others or making and keeping friends. This can worsen the
problem because it makes them feel like they're in an isolated situation.
One of the goals of therapy is to help improve your social skills if you've
been struggling with serious problems for a long time. You cannot solve all
your problems on your own - so it's important to reach out and connect with
others to get the support you need to make life better.

8. Hiding symptoms in CBT

Many people who struggle with depression and anxiety self-diagnose that
they are 'too depressed' or 'too anxious. This often stems from the fact that
people may not want to take medicine as it's believed to be potentially
dangerous. If someone gets used to using alcohol or drug to deal with their
symptoms, they may continue doing so even when they've learned how
pointless and harmful it is. One of therapy's goals is to learn what helps you
conquer your conditions but also helps you get rid of your self-diagnosis so
you can achieve your goals in life.
 What is CBT?
A therapy that looks at how thoughts and feelings play a role in each
person's life. It focuses on how thoughts, feelings, and behaviors can be
used to overcome difficulties or achieve personal goals.

Cognitive-behavior therapy (CBT) is a practical therapeutic approach used

to treat various issues and conditions successfully. Many studies have laid
the groundwork for using CBT, identifying treatment efficacy, and helping
develop evidence-based practice (EBP). EBP is a research study that tests
the effectiveness of treatment protocols on a large group of patients. The
goal is to determine if the treatment protocol will successfully treat a given
condition or symptom while minimizing adverse effects. As an example, CBT
was identified as an effective treatment for depression by numerous
scientific studies.

CBT is a behavior change therapy. It was developed in response to the

complexity of human behavior and problems. The restructuring of thought
and behaviors that occurs during CBT is achieved through the process of
applying CBT's results-based approach to PAPs (Problem Assessment and
Planning) within a HALT (Helping Allowed Teaching Long Term) mode
within an SIT format (Structured Interviewing Technique).

Cognitive-behavioral therapy (CBT) was first described as a new approach

in an unpublished paper in 1967 by Aaron T. Beck. He attributed it to the
work of Aaron T. Beck, Zev Wanderer, and colleagues and published it in
1969. It has been used to treat various mental disorders, including mood
disorders (e.g., depression), anxiety disorders (e.g., generalized anxiety
disorder), eating disorders, personality disorders, and substance
abuse/addiction. In addition, it is commonly used as an adjunct to alternate
treatment approaches, including drug therapy and other talk therapies such
as psychodynamic or humanistic therapy.

It is one of the most widely used psychotherapeutic approaches, particularly

in the context of cognitive therapy and in the treatment of depression. It is
also used as a primary treatment approach in treating anxiety disorders.
CBT is growing in popularity among practitioners and has been deemed by
many to be both practical and mainstream.
The philosophy behind CBT rests on a belief that psychiatric disorders
derive from an interplay between personal history and current life
circumstances, combined with a complex set of attitudes about oneself,
others, and the world at large. This formulation fits well with the data from
genetic research that has found vulnerability factors for developing certain
disorders (e.g., substance abuse) in specific brain regions. The goal of CBT
is to identify these vulnerabilities and then compensate for them through
behavioral modifications.

CBT combines several techniques that have been used to treat mental
health disorders. The approach differs from other approaches in that the
therapist may focus on what a person did or thought or how they felt, but
CBT considers these things by looking at the actual behavior, thoughts, and
feelings. CBT focuses on changing behaviors, which can be done by
addressing their triggers and helping clients change their patterns of
reactions related to those situations. It also centers on helping people deal
with their current problems and make changes for the better. CBT also
focuses on applying new behaviors in real-world circumstances, which
makes it an effective tool for treating clinical depression and anxiety.

Beck first proposed that abnormal behaviors develop through his cognitive
triad: (1) negative thoughts leading to negative expectations and
assumptions; (2) a negative self-image, leading to failed goals and
frustration and (3) a negative cycle of events that made the problem worse.
He demonstrated further that this triad develops into a vicious circle, with
each element reinforcing the other two. To treat patients with depression,
CBT attempts to reverse these processes by changing the way they think
about the world and their behavior.

The roots of CBT can be traced to the investigations of George Kelly and
others regarding the higher mental processes of humans. However, the
theory advanced by Beck and colleagues was first published in 1969 as a
monograph entitled: "Behavior Therapy and the Cognitive-Behavioral
Approach." This publication brought the work of Aaron T. Beck, Zev
Wanderer, Edna Foa, and their colleagues to the attention of a wider
audience.
Cognitive-behavioral therapy (CBT) is a child or developmentally new
psychotherapy approach based on the cognitive model of human behavior
development. Cognitivism states that human beings are not passive
organisms but active agents that develop through interacting with their
environment. Four primary processes occur in development: (1) the
acquisition of knowledge, (2) evaluation of information, (3) patterning, and
(4) action. In addition, this approach posits that dysfunctional patterns can
be followed or "played out" in various environments, such as families and
relationships. Eric Berne developed a taxonomy for understanding the
development of behavioral problems based on his observations and
experimental studies conducted with children during his research from the
1940s through the 1960s.

CBT was introduced in 1967 by Aaron Beck, who applied to it the methods
he had used successfully as a clinician in treating depression. It was later
developed to treat anxiety by Albert Ellis, who was trained by Aaron Beck
and also influenced Donald Meichenbaum, M.D.

CBT is a cognitive therapy approach grounded in the cognitive paradigm of

human behavior. The theory asserts that many problems result from
maladaptive or unhelpful cognitions (thinking or beliefs) and behaviors
(actions) that develop over time based on one's personal history and life
experiences. These thinking and behavioral processes are called schematic
representations of the world; they reflect one's expectations, influencing
behavior. Individuals can be taught to identify their schemas, recognize
when they are triggered, and adapt their schemas to real-life experiences.

According to the theory, schemas develop through learning, conditioning,

and personal experience. For example, a person who has battled several
bouts of illness or received repeated criticism from a parent may develop
the schema: "I am not lovable or worthy." This belief will likely cause the
person to behave in ways that elicit further criticism or new illness to fulfill
what he perceives as his destiny.

This form of therapy can be thought of as psychoeducation. The focus is on

helping a patient to recognize, understand and analyze issues in their life.
This information may help the individual develop more adaptive coping
skills.
CBT treats various clinical conditions, including mood disorders, personality
disorders, eating disorders, and anxiety disorders such as social phobia and
obsessive-compulsive disorder (OCD). Its effectiveness has also been
demonstrated in several specific situations:

Several pieces of evidence have shown that CBT has effectively treated
people with depression in the past few decades. For example, one meta-
analysis found that: "Among depressed outpatients, cognitive therapy was
significantly more effective than medication management. Although
publication bias likely contributes to the apparent superiority of cognitive
therapy, this analysis rigorously tested the effects of each treatment
strategy and demonstrated its superiority over medication management."

Another meta-analysis found that "Cognitive therapy in addition to standard

care was significantly more effective than standard care alone or no
therapy." In several randomized controlled trials, CBT is more effective than
pharmacological treatment (e.g., SSRIs) for depressed patients. One meta-
analysis found that "among depressed outpatients, cognitive therapy was
significantly more effective than medication management.

Is there evidence for CBT?

A meta-analysis of studies on the efficacy of CBT for depression by the
Agency for Healthcare Research and Quality (AHRQ) concluded that CBT is
effective in reducing symptoms of depression but that CBT is not as
effective as antidepressant medications in treating depression. This meta-
analysis included thirty randomized controlled trials involving over 2,000
patients.

A second large meta-analysis by AHRQ also supported the conclusion that

CBT is more effective than no treatment in reducing chronic pain symptoms.
This meta-analysis included 15 randomized controlled trials involving 769
patients with chronic pain.

The review concluded that CBT was effective after 6 to 12 weeks of

treatment. In addition, it found no significant differences between CBT and
treatment in reducing depressive symptoms, pain, or adverse events.
A review by AHRQ of the effectiveness of medications for depression
concluded that medication alone is no more effective for treating depression
than the combination of therapy and medication. The review assessed a
total of eleven randomized controlled trials involving 3,000 patients with
depression. The authors concluded that "for most people with major
depressive disorder, a combination of therapy and medication is more
effective than either intervention alone."

Therefore, evidence for CBT is mixed, and the methodologies employed can
lead to different conclusions. Moreover, the concept of CBT is founded upon
a developmental model of human behavior. Many studies show that, at least
in some instances, CBT has proved less effective than other treatments. In
general, a cognitive-behavioral theory is not more effective than
psychotherapy.

A 2006 Cochrane systematic review of the role of behavioral interventions

in the treatment of depression between 1997 and 2003 concluded: "There
was insufficient evidence to allow a firm conclusion as to whether
behavioral therapies have any advantages over drug therapy. However,
interventions in this area do not seem to be any more effective than drug
treatment alone and should be considered a viable, if not preferred, option
for treating depression."

The Cochrane review on randomized controlled trials also found that

Cognitive Therapy is no more effective than drug therapy in treating mild
depression. However, the review also noted that "there is insufficient
published evidence [i.e., randomized controlled trials] to allow conclusions
on interventions such as cognitive therapy and supportive therapy."

However, given the approach's limitations in gaining scientific consensus,

CBT remains one of the most popular methods therapists use. In addition,
despite its limitations as an evidence-based treatment model. CBT is a form
of effective treatment for several conditions, including social anxiety
disorder, depression, marital problems, and post-traumatic stress.

CBT differs from psychodynamic or interpersonal psychotherapy in that the

cognitive processes emphasized by CBT tend to be more scientific than
those of psychodynamic and interpersonal models. CBT focuses on
observable behavior in the here-and-now to determine whether past events
may have influenced present thoughts and feelings. CBT is therefore
considered more naturalistic than other therapies because it relies less on
information from past experiences.

CBT differs from behavior therapy because it focuses on the present rather
than the environment or context. In addition, behavior therapy uses
reinforcement and punishment as principal tools, whereas CBT does not
rely primarily on rewards or rewards for change.

In psychotherapy, patients are typically involved in two-person dialogues,

either alone or with a therapist or a group of peers. In general, CBT
assumes that humans have an internal voice (the "self"), which is often
described as the "inner critic." The role of this inner critic is to evaluate the
patient's thoughts and feelings and to tell us whether we are being "good"
or "bad," etc.

CBT is known for its focus on core processes believed to underlie many
disorders, including depression, anxiety, and obsessive-compulsive disorder.
These core processes generally include global evaluations of one's self,
others, life, and the belief that events are uncontrollable.

The term "cognitive fusion" in CBT describes how humans relate to their
thoughts. When a person is cognitively fused with their thoughts, they
engage in thinking at a level at which they experience emotions. When
people engage in cognitive fusion, it is common for them to believe that
their thoughts reflect reality or that their thought is valid interpretations of
reality. However, these thoughts are not necessarily accurate reflections of
external reality (as opposed to internal reality), making this person more
prone to develop biases and beliefs, leading to more significant negative
emotional states such as anxiety and depression. CBT can also be taught to
patients in group therapy, which is more effective than individual therapy.

CBT can be used in combination with pharmaceuticals and other

therapeutic measures. However, the evidence for CBT's effectiveness as a
treatment for depression remains inconclusive. There are several limitations
that researchers have identified when assessing the effectiveness of CBT as
a psychological treatment, including:
When compared with other therapies, not enough research has been done
to determine whether or not CBT is an effective treatment. Also, some
studies have suggested that people do well without any additional
intervention besides medication, support groups, or self-help organization
meetings (like Alcoholics Anonymous).

CBT is often used by people suffering from depression for several reasons.
First, CBT often helps sufferers better understand the thoughts that cause
their depression and may help sufferers learn skills that increase their
ability to resist the negative consequences of these thoughts. For example,
CBT may help people with depression cope with social anxiety and
interpersonal conflicts and regulate cognitive processes. Second, evidence-
based practices are software or a process that combines what is known,
what works, and what works better than other practices or interventions.

How are the CBT sessions conducted?

The veteran counselor will begin by asking about the issue the patient
faces. The counselor will then ask the patient to describe their thoughts and
feelings. The counselor will then ask questions that help the patient identify
negative assumptions and evaluate evidence that challenges these ideas.
This goal is to help the patient understand their situation better and
consider other possible explanations for how they feel or perceive a
situation. This helps them develop more productive coping skills, including
reducing their anxiety or depression.

The agent is the primary agent of change for the client. The patient
identifies and works on the circumstances that create their problems. It is
necessary to do a severe analysis of the situation to understand how this
affects a particular individual. Every session begins with identifying positive
and negative aspects of therapy, skills that need help, and goals that should
be achieved by the end of the session. Then, the agent will use specific
techniques to communicate with the patient to achieve these goals. These
techniques may include expressing approval or disapproval, use of
empathetic language, distraction techniques (such as jokes), praise
statements, unrealistic statements, change statements (such as "let's start
over"), and more. The main goal is communicating so that the patient
understands and reacts positively. The techniques are used according to the
techniques by which the patient identifies their problem.

The information processing of a human being is the way a person takes in

information, decides what that information means, and responds to it.
Information processing includes all the steps individuals take to understand
their experiences and surroundings.

CBT focuses on four primary processes, such as:

a. Cognitive appraisal

This focuses on how people evaluate their situations, including their

thoughts about the world and themselves. People are constantly evaluating
situations for things like risk and rewards. As a result, people make
predictions about what will happen based on their past experiences with
similar experiences. For example, if a storm is nearby, a person may think,
"I hope the tree outside my window doesn't fall," or "I hope we don't lose
power in this storm." Together, cognition and emotion are called "appraisal
processes." In therapy sessions, the counselor will help patients identify
their negative thought patterns and evaluate evidence that challenges these
negative patterns of thinking.

According to Beck, information processing is biased towards negative

experiences in an unhealthy state. As a result, patients tend to ignore
positive experiences and magnify the importance of negative ones. In
therapy sessions, the counselor will help patients identify their negative
thought patterns and evaluate evidence that challenges these negative
patterns of thinking.

b. Emotion regulation

Emotion regulation focuses on how people manage and control their

emotional responses. Emotions are crucial to an individual's overall
psychological well-being. Experiencing intense emotions can sometimes be
beneficial (for example, in response to a situation threatening safety).
However, when people experience extreme or prolonged emotional states,
they can lead to problems like anxiety or depression. Patients learn to
identify and challenge negative thought patterns by identifying how these
thoughts cause them to act in such a way. For example, if someone is
overwhelmed by intense emotion, this person may begin meditating and
thinking about their worst possible case scenario.

Interviewing patients allows the psychiatrist or psychologist to determine

their mental state at a particular moment. The goal is for the therapist to
know where a patient stands emotionally so that they can provide the most
appropriate treatment option. In therapy sessions, the psychiatrist will ask
questions that help patients identify how they feel in different situations.
The psychiatrist will then help the patient identify negative thoughts and
evaluate evidence that challenges these negative thinking patterns. In this
way, patients learn to manage their emotions more effectively.

c. Behavioral analysis

The behavioral analysis focuses on how people behave in different

situations. For example, someone may react to a stressful situation by
feeling depressed or anxious. Still, they may also cope with it by sleeping
excessively, overeating, abusing alcohol or drugs, withdrawing from others,
becoming aggressive or violent, and so on. The therapist will help the
patient identify behavioral patterns in therapy sessions and evaluate
evidence that challenges these behaviors. Patients will learn how to replace
maladaptive behaviors with adaptive ones through a process called
"behavioral analysis.

d. Cognitive reshaping

Cognitive reshaping focuses on how people think about themselves, others,

and their situations. This is typically called self-talk by therapists. People
constantly think about themselves and their experiences in terms of "self-
schema," or schemas. Schemas are like mental categories that people
organize their experiences into (e.g., "I am a smart person who is good at
schoolwork"). According to Beck, most individuals have a global schema to
evaluate themselves, which often leads to biases in thinking (for example,
catastrophizing). Patients will learn to change their negative schemas into
more realistic ones, leading to more positive self-talk.

One of the key concepts in cognitive therapy is "automatic thoughts." These

are patients' immediate, unconscious responses when they encounter a
situation. These automatic thoughts then cause patients to feel and behave
in specific ways, which leads them to feel depressed or anxious. The goal of
cognitive therapy is for patients to be able to recognize their automatic
thoughts and evaluate evidence for patients to correct their thinking and
change the way they view situations.

Patients need to take steps to overcome their negative thinking patterns.

First, patients must recognize their automatic thoughts and evaluate
evidence, allowing them to correct their thinking and change how they view
situations.

Recognize negative automatic thoughts: For patients to recognize their

automatic thoughts, therapists must help patients identify what a thought
is. Once this has been identified, therapists can teach patients how to
recognize when they are having these types of thoughts. Most often, a
therapist will ask the patient about a recent situation where they
experienced anxiety or depression and encourage them to describe their
experience. By sharing what happened and how they felt, patients will
eventually begin thinking about the situation in a negative way. This is
where automatic thoughts are at. If a patient can see that their thought
process has gone from one thing to another, it is easier to spot automatic
thoughts when they occur.

An example is if someone suddenly becomes upset after someone yells at

them on the street. The person will automatically think, "I'm never going to
get over my depression because people keep yelling at me," which causes
them to feel worthless, hopeless, and depressed. At this point, the patient
must evaluate evidence that challenges these automatic thoughts to correct
them (see below). Once the patient can identify their automatic thoughts,
they must evaluate evidence that challenges them.

Evaluate evidence: To overcome negative automatic thoughts, people must

evaluate evidence that contradicts them. Examining this evidence is
sometimes called "cognitive restructuring" or "cognition." Essentially,
patients will have to examine the same situation from different viewpoints
and think about what things may be out of proportion or inaccurate to
correct the automatic thought. Taking a new perspective is the goal.
 What could go wrong with this therapy?
A few possible problems with this approach are:

1. It takes time for a person to change their thoughts and behaviors. This
means that therapy might take more time than the patient is willing to
spend. However, this therapy can be beneficial in helping a person work
through issues that have been bothering them for years. For example, the
therapist could help the patient look at their automatic thoughts, challenge
them to be more accurate, and improve negative thinking patterns. After
several sessions, the patient should become more accurate in evaluating
evidence that challenges their automatic thoughts and, therefore, can
change their behavior.

2. Automatic thoughts can be tough to spot. For example, if a person

believes for years that they are unlovable and has not been able to develop
close relationships, it is hard to know what it will take for the patient to see
beyond these automatic thoughts. In this case, the patient may need help
from a professional specializing in psychotherapy.

3. It might be hard for patients to identify how they typically think about
themselves and their problems. This is especially true if a person does not
believe in therapy or if therapy was rejected before. Still, the therapist can
ask about something the patient did recently that made them feel better and
encourage them to talk about what they thought was wrong with
themselves before therapy started.

4. Therapy is supposed to be a trusting relationship where the patient and

the therapist feel comfortable expressing themselves. If a patient is afraid
they will say something wrong or the therapist will judge them, they may
not be able to form a trusting relationship with their therapist. This could
lead to negative thoughts and behaviors and even more negative thoughts.

5. The therapist might not be familiar enough with cognitive therapy to be

effective. However, cognitive therapy is the most studied and evaluated
form of psychotherapy, so therapists should have some training.

6. Cognitive therapy requires patients to be aware of their feelings and

think about them simultaneously. If a person is depressed or having a panic
attack, this may not be very easy for them to do. It may even make them
feel worse by focusing on how they feel instead of trying to change how
they think about a situation and what effect those thoughts have on them.

7. Cognitive therapy may not be effective if a person has never been able to
work through their problems to overcome their negative thoughts and
behaviors. In addition, even throughout therapy, some people may not find
themselves more accurate at identifying negative automatic thoughts and
evaluating evidence as they learn to change their thinking.

8. Cognitive therapy requires that patients actively work through the

sessions, which can be difficult for some people who are having problems
with anxiety or depression. In this case, cognitive therapy might not be
effective because it does not address the problem that caused a person's
troubling behavior in the first place. Instead, the patient needs to find a way
to address the root of the problem.

9. Many people might not understand what cognitive therapy is or how it

works, which could cause them to reject it immediately. However, a
therapist can explain that this therapy helps patients overcome negative
thinking patterns that have been preventing them from improving their lives
and functioning better in certain situations.

Therefore, cognitive therapy is helpful for patients who are willing to put
time into working on changing their thoughts and behavior. This can be
difficult for people who have not been able to work through their problems
in the past and does not result in immediate changes, but it is beneficial for
all people to improve their lives mentally.

The therapeutic relationship forms the foundation of cognitive therapy.

What distinguishes the therapist from a mental health professional who sees
patients for longer than a year (e.g., psychiatrist, nurse practitioner, clinical
psychologist) is that cognitive therapists do not just give advice and
direction on how to think about a situation to solve it. Instead, the therapist
works with the patient to improve their relationship with themselves and
the world beyond to help them overcome negative thinking. To do this,
cognitive therapy therapists must be knowledgeable about cognitive
therapy and also talk about other psychotherapy methods.
It is essential for a therapist to be well-versed in cognitive therapy and how
it differs from other types of psychotherapy. The use of feedback from the
patient is one example where it differs from other forms of psychotherapy.
In most types of psychotherapy, patients are often given homework
assignments such as writing letters home or journaling to give themselves
the motivation to continue treatment even after they complete their
sessions (e.g., psychoanalysis). Conversely, cognitive therapy focuses on
what the patient does to avoid their issues and how to deal with them.

Cognitive therapists also emphasize that it is not enough for a person to

overcome a problem with their thinking; they must learn how to think about
it in different ways that are not automatic and negative. Therapy is about
helping the patient become more accurate at evaluating evidence and how
past experiences have affected their current relationships and interactions
in life.

The goal of cognitive therapy is not just to solve the patient's problems but
to achieve a better quality of life. Thus, cognitive therapists try to
demonstrate ways in which they can improve upon their relationships with
themselves, other people, and society as a whole.

Cognitive therapy can be beneficial in many ways. For example, one way it
can help someone is by helping them overcome depression and anxiety by
changing their automatic thoughts to more realistic ones. In addition, with
the help of a therapist, a person can learn to develop an accurate self-
image.

This kind of therapy could be helpful for people who feel stuck in negative
thinking patterns, which leads to depression. A therapist could help the
patient understand these negative thoughts and work through them. In
addition, the therapy can help patients who feel hopeless about their
circumstances, for example, who feel that everyone is out to get them or
that they are unlovable.

For example, a person may believe that everyone hates them for what
happened in their childhood or because they did not do something right in
the past, leading to sadness and low self-esteem. They may feel that
everything is their fault and think they are not good enough. With the help
of a therapist, however, this person can learn to recognize these automatic
thoughts, evaluate evidence that challenges them, and realize how this type
of thinking is inaccurate.

Types of CBT

Different types of CBT include:

1. Rational emotive behavior therapy

Rational emotive behavior therapy (REBT) is a type of cognitive behavioral

therapy ("CBT") that focuses on changing a person's thoughts and behaviors
to overcome depression, anxiety, and other disorders. It was developed in
the 1930s by Albert Ellis. This form of CBT emphasizes that people should
reason to change their feelings, which are not as accurate as their beliefs
(e.g., such as: "I am unlovable" or "I always fail"). People should also try to
understand themselves to change their behaviors (e.g., by accepting
themselves and others).

2. Interpersonal therapy

Interpersonal therapy ("IPT") was developed by Robert H. Skurnik and

Jerome C. Wakefield in the 1960s to treat depression. It focuses on
improving relationships with others and enhancing self-esteem through
learning more effective communication skills and how to solve problems
with others positively.

3. Mindfulness-based cognitive therapy

Mindfulness-based cognitive therapy ("MBT") is an alternative form of

cognitive behavioral therapy that emphasizes mindfulness training,
relaxation techniques, and other exercises to improve mental health by
helping people become more aware of their thoughts and emotions, which
help them live happier lives.

4. Solution-focused brief therapy

Solution-focused brief therapy ("SFBT") is a type of cognitive behavioral

therapy founded by Dr. David Burns based on cognitive behavioral therapy.
This form of CBT does not include the long-term strategies used in other
forms of CBT but instead focuses on the past week, two weeks, one month,
and three months to improve mental health.

5. Motivational enhancement therapy

Motivational enhancement therapy ("MET") is a type of CBT that focuses on

enhancing one's motivation to change problems in one's life. This form of
CBT was developed by Dr. David Burns, based on cognitive behavioral
therapy, focusing on planning activities to perform positively and finding
ways to enhance motivation.

6. Mindfulness-based stress reduction

A mindfulness-based stress reduction is a form of meditation initially

developed in 1979 by Jon Kabat-Zinn for medical patients with chronic pain.
Still, it has since been adapted for almost any group of people struggling
with a mental health problem or emotional disorder.

7. Dialectical behavior therapy

Dialectical behavior therapy ("DBT") is based on a model of mental health

developed by Dr. Marsha Linehan in the 1980s. This form of CBT was
developed for patients with borderline personality disorder and is currently
used to treat others struggling with a mental health problem or emotional
disorder.

8. Acceptance and commitment to therapy

Acceptance and commitment therapy ("ACT") is a form of cognitive

behavioral therapy developed by Dr. Steven C. Hayes, based on the work of
Dr. David Spiegel. CBT aims to improve a person's quality of life and
independence through mindfulness exercises, which focus on accepting the
present moment, being nonjudgmental, and developing positive
relationships with others.

9. Acceptance and commitment to therapy for addictions

Acceptance and commitment therapy for addictions ("ACT-A") is a type of

CBT developed by Jon Pincus that focuses on improving motivation to
change problems such as depression, addiction, or eating disorders that
they face in their lives through establishing an acceptance framework (e.g.,
accepting the reality of their situation). This form of CBT focuses on how
the past cannot be changed and that changing behavior is the only way to
improve one's life.

10. Dialectical behavior therapy for borderline personality disorder

Dialectical behavior therapy for borderline personality disorder ("DBT-

BPD") is a type of CBT developed by Marsha M. Linehan as a modified
version of dialectical behavior therapy ("DBT"). This form of CBT was
developed for patients with borderline personality disorder and is currently
used for people struggling with mental health problems or emotional
disorders. DBT-BPD focuses on helping patients to learn skills to cope with
their emotions, control behaviors (e.g., self-harm and suicidal thoughts),
improve relationships with others, healthily solve problems, and manage
their lives.

11. Visually-based acceptance and commitment therapy

Visually-based acceptance and commitment therapy ("VACT") is similar to

"acceptance and commitment therapy" ("ACT") but includes the use of
virtual reality exposure to treat anxiety disorders. This form of CBT was
developed early in the 21st century by Drs. Matthew J. Friedman, Steven C.
Hayes, Anthony Pignone, Sherry A. Stewart, Jon Soderstrom, Matthew
McKay, and Arthur Cavanagh help people with anxiety disorders caused by
traumatic events (e.g., such as sexual assault).

It is important to note that many people oppose CBT as therapy. They argue
that data supports the old approach, or "talk" therapy, as the best solution
for mental health problems. For example:

1. Talk therapy has always been the primary form of treatment for
depression and other mental disorders

2. The type of CBT used by many psychologists and therapists (such as

cognitive behavior therapy and cognitive-behavioral therapy) has shown
adverse effects on some types of people (e.g., people with a borderline
personality disorder)
3. If you try to force someone to change their thoughts or behavior using
CBT, it will probably result in them doing more harm than good (e.g., self-
harm or suicide)

4. Using CBT for emotional problems like depression or anxiety can cause
more harm than good (e.g., anorexia, bulimia nervosa, etc.)

5. There is little evidence to support the use of CBT in mental health

problems

6. other forms of therapy have shown an advantage in treating mental

health problems (e.g., yoga, mindfulness exercises, evolutionary psychology,
Zen)

7. This type of therapy is very different from what most people are used to
when they go to a doctor's office or psychologist's office

Many people oppose this form of therapy, but CBT therapists need to
address people's concerns with our approach. Most arguments against this
form of therapy focus on how it is not as effective as talk therapy or causes
more harm than good. Still, these arguments do not consider what CBT
means in a modern context (e.g., many different CBT types have different
effects).
 CBT- How does this method work?
Cognitive behavior therapy (CBT) is a type of psychotherapy that helps
people adopt and maintain changes in their thoughts, feelings, beliefs,
behaviors, and relationships. It is based on the idea that our thoughts cause
our feelings, and then these feelings lead to actions and interpersonal
interactions. So to change any of these things, we need to alter how we
think about them.

Cognitive behavior therapy is a well-researched, structured, and manualized

approach to psychological treatment that is effective in treating many
disorders.

CBT focuses on thinking patterns leading to negative or unhealthy emotions

and behaviors. It teaches people different ways of thinking about things that
help them feel better about themselves and their life. CBT also aims to
reduce 'maladaptive' behaviors, such as drug or alcohol use, in favor of
healthier coping methods.

For instance, CBT could help you learn how to stop smoking by helping you
predict how certain situations trigger your cravings via your thoughts and
feelings. The theory behind CBT states that your thoughts about the
situation drive your craving to smoke. So, for example, if you're nervous
about a presentation you have to give at work, you might think, "Everyone is
going to be judging me, and I'm going to fail miserably in front of everyone."
These thoughts can trigger anxiety or stress and make you crave a cigarette
to feel better. In this way, CBT helps people identify and cope with their
dysfunctional thoughts.

Cognitive behavioral therapy teaches basic self-help skills (such as

relaxation techniques) individually or within a group setting. These skills
are then practiced in between sessions, and over time, people learn to feel
better about themselves and their life, which decreases their anxiety, stress,
depression and urges to use alcohol or drugs.

Cognitive Behavioural Therapy aims to help patients identify harmful or

unhealthy ways of thinking that lead to negative emotions and behaviors.
For example, if you constantly tell yourself that you must succeed at
everything and anything, you may get very stressed out when you do not.
Likewise, if you think everyone must like and approve of everything you do,
being criticized may make you feel terrible.

Cognitive Behaviour Therapy helps people develop different ways of

thinking about situations to learn to feel better about themselves and their
life. No two patients are alike, so the goal is to help people identify how
they think, feel and act when feeling down or depressed. For example, if a
patient has relationship difficulties, cognitive behavioral therapy aims to
help them understand their thoughts and feelings about the relationship.
The therapist will help the patient develop different ways of thinking about
the partner to decrease negative thoughts and feelings.

How do I get screened for cognitive behavior therapy?

There are several ways to get screened for cognitive behavior therapy. A
cognitive behavioral therapist will weigh the patient's motivation, ask them
questions about their thoughts and feelings, and determine whether or not
they have the capacity to make changes on their own. If they feel they
cannot change themselves with proper support, they can be referred to a
therapist with more experience in CBT. A self-help book is available for
those who feel they can handle it independently.

Ways to get screened for CBT include:

a. By visiting a therapist, who will ask questions regarding what the patient
believes about themselves.

b. Through CBT Self Tests.

c. Through assessment tests.

d. Referral by a friend or family member

Cognitive behavioral therapy usually involves four to six sessions per week.
However, this may be less if the patient can handle their problems
independently or with family and friends' support. In some cases, cognitive
behavioral therapy can be a one-on-one treatment, but in other cases, it may
need to be done in a group setting. The CBT therapist will also help patients
develop skills they can use when feeling stressed or depressed to help them
cope with the situation and prevent them from turning to alcohol and drugs
for relief.

Medications are not typically used in cognitive behavior therapy because

the goal is to stop the thoughts that lead to negative emotions and
behaviors. Medication treats problems by altering thoughts, whether
anxiety, stress, or depression. Even though medications can alter how you
think and behave, they are ineffective in treating depression and anxiety.
CBT helps treat these conditions by changing one's thinking patterns rather
than altering how people feel or act. So medications are not typically used
in cognitive behavioral therapy.

CBT only works effectively when the patient can identify their negative
thoughts and feelings and develop strategies to alter these thoughts. Even
though CBT is a highly effective treatment, it can be time-consuming and
difficult. Some patients do not have the time or desire to work on their
problems daily. So the patient needs to understand that therapy may take
months or even years before they feel better. Cognitive behavioral therapy
requires intense self-help, and many people do not have the motivation or
energy to see results quickly. The therapist will work closely with the
patient, giving them encouragement and feedback as they progress through
therapy. If the patient does not see results or is unwilling to make changes,
the therapist may explore other options, including medication or a more
intensive form of therapy.

Moreover, evidence-based treatments such as CBT are not the be-all and
end-all of treatment. Sometimes the patient's symptoms can be resolved
without therapy, or in some instances, and patients will need medication for
their anxiety, stress, or depressive symptoms. As with any treatment,
cognitive behavioral therapy works best with other therapy and medication.

How long does CBT take?

In most cases, cognitive behavioral therapy can take months to see results,
so it is essential to keep up your effort throughout your therapy. It is best to
address your thoughts and feelings as soon as you notice them, as this will
help prevent you from turning to substances or negative behaviors such as
drugs or alcohol in a desperate attempt to feel better. The patient must
understand that the therapy can take months or even years to work
effectively.

Patients who do not feel like their time is wasted may try to finish the
treatment without going into more detail about their thoughts and feelings.
However, this may not be possible. Even if you think your therapist is
overstepping their bounds with questions such as "Why are you still
depressed?" complete honesty is necessary to help the therapist find
effective ways to change your thought patterns. It is essential to complete
the therapy as best as possible, as it may take months or years to see
results.

Cognitive behavioral therapy is based on the idea that you can change your
negative thoughts to feel better. If a patient does not see results or is
unwilling to make changes in their life, the therapist may explore other
options for treatment.

In addition, cognitive behavioral therapy is based on the idea that you can
change your negative thoughts to feel better. If a patient does not see
results or is unwilling to make changes in their life, the therapist may
explore other options for treatment. Therefore, if the patient doesn't believe
they need therapy or are unwilling to do what it takes to get better, this
type of treatment is ineffective.

This method takes approximately six months to a year. In the case of

addiction and substance abuse, the therapy is usually based on a 12-step
program. This type of therapy is best if the patient is open to trying it. If
they are not open to it, they may do better with cognitive behavioral therapy
as it focuses more on changing thinking patterns that are causing addictive
behaviors as opposed to your emotional state.

Cognitive behavioral therapy is a crucial component of addiction treatment,

as it helps patients better understand their thoughts and how they impact
their behavior. CBT teaches patients how to approach negative experiences
in a way that does not cause anxiety or depression. This method is best if
the patient is open to trying it. If they are not open to it, they may do better
with cognitive behavioral therapy as it focuses more on changing thinking
patterns causing addictive behaviors instead of your emotional state.
The main goal of cognitive behavioral therapy is to eliminate psychological
symptoms and emotional distress that interferes with daily life. This can
happen by changing negative thoughts, behaviors, and emotions. In
addition, CBT aims to teach patients how to identify their dysfunctional
thoughts and develop coping skills through problem-solving. The self-help
book "Feeling Good" by David Burns provides detailed instructions on
identifying harmful thinking patterns and developing healthy coping skills.

In the case of depression and anxiety, the goal is to help patients learn how
to identify their thoughts, emotions, and behaviors that make them feel
better. For example, if a patient feels better after doing exercises, reading
books, or taking medication or therapy/medication, this demonstrates that
CBT worked. The patient needs to understand that changes in behavior may
not be immediate but will come with time.

Cognitive behavioral therapy is effective when the patient can identify their
negative thoughts and feelings so they can develop skills to alter these
thoughts. Unfortunately, cognitive behavioral therapy will not work in
several instances because the patient has a psychological disorder.
However, many therapists use CBT with other techniques, such as
medication or additional therapy, to help patients resolve their problems.

What is a typical session like?

The first cognitive behavioral therapy sessions are essential for the
therapist to get to know their patient and the patient to get a feel for how
the therapist works. In addition, patients want to feel comfortable talking
about their issues and that they can trust their therapists with personal
information. For example, if a patient is anxious about going on dates and
one of the goals is to go on more dates with different people, then this
should be discussed during the first session so that it can be addressed in
future sessions.

During the first session, the therapist may ask many questions to help guide
the patient. This will give them an idea of whether they need individual
therapy or should be referred to a counselor, social worker, psychologist, or
another expert in their area.
This helps the patient decide if they want to continue doing cognitive
behavioral therapy with the therapist or find a different one. It is usually
based on how well they feel after talking with their therapist, how much
trust and confidence they have in them, and how helpful they have been so
far.

As cognitive behavioral therapy progresses, it may take longer to complete

specific exercises because there may be more information to share and
ideas about what is going on that might be helpful. Most therapists do not
rush their patients and help them work at their own pace.

The therapist and patient may also decide to explore specific topics deeper
in future sessions.

The second session may address how the patient feels so far, and the
subsequent sessions may help them understand the therapy better.
Moreover, the therapist will continue to help the patient identify negative
thought patterns and coping skills. This involves looking at the different
situations that may have occurred in previous sessions and deciding how
the patient can alter their negative thoughts and feelings.

In addition, patients may bring homework to do outside of sessions and

discuss it with their therapist during sessions. This helps them understand
what they need to work on more when they aren't in therapy.

The therapist will help them identify areas where they are doing well and
areas that are hard for them. The therapist will also use various techniques
to help the patient work on these problems, including changing their
thought patterns or helping them learn new ways to cope with life stressors.

What are the Components of CBT?

CBT components are skills that the patient will learn during cognitive
behavioral therapy. Some of the most common components include:

a. Observation.

Observation is the ability to notice a situation or thought when it happens.

This also helps further the therapy by identifying dysfunctional thought
patterns and actions. For instance, a patient may say that he or she forgets
his keys because they are too focused on other tasks, like applying for
another job.

In cognitive behavioral therapy, noticing what is happening and then

changing these circumstances to help the patient cope better with life
issues helps develop new coping skills that can be used later to deal with
similar situations. In addition, thinking helps patients change their behavior
and thoughts to feel better emotionally and mentally.

b. Self-monitoring and reflection (5-second test).

The patient is asked to look at their current situation in this exercise. Then,
after noticing the situation, how they think about it (cognitively), and what
they feel (emotionally), they are asked to take a 5-second pause before
acting on the situation. This helps them make better decisions in future
situations by helping them identify their feelings and thoughts before acting
on these harmful thought patterns. In addition, this considers that some
people have difficulty making quick decisions that negatively impact their
lives.

The 5-second test can be performed at any time during a session. Patients
can do this exercise any time of the day or night to help them identify
unhealthy thought patterns or specific situations or emotions.

The following is an example of how this 5-second test is performed.

1. Notice what is happening (the first two seconds).

2. Think/Identify your thoughts about the situation (the next three seconds).

3. Identify how you feel emotionally (the last two seconds).

4. After the five seconds, identify the situation and think about it for a few
more seconds. Still, this time do not overthink or think about it negatively
anymore (a few minutes will pass by on average). This helps patients
change their perspective of situations, so they have more control over their
emotions instead of allowing them to control them.

c. Cognitive restructuring.

In cognitive behavioral therapy, patients learn how to change their thoughts

about situations and that these thoughts may not be valid. Cognitive
restructuring helps patients change these harmful thought patterns and
adjust their reasoning during difficult situations to feel better mentally and
psychologically.

For example, A person in a romantic relationship has been caught cheating

and is blaming the relationship for this betrayal. The patient may think that
if they were not in a relationship, they would not cheat on them, and it is all
the fault of the other person for cheating because that person does not treat
them well enough.

This is an example of a distorted thinking pattern and one that blames

others for the patient's distress. In cognitive behavioral therapy, the patient
learns to identify these distortions more clearly and then choose healthy
thoughts to replace these to feel better emotionally.

d. Behavioral experiments.

Behavioral experiments help patients change their habits or routines to feel

better mentally and psychologically. For instance, a patient may have
problems at work because they cannot focus on their job due to being
distracted by other things going on in life. So the patient may try this
experiment:

1. Notice what is happening.

2. Think about the situation for a few seconds.

3. Identify the behavior that they want to change.

4. Perform the behavioral experiment by making this change in their

routine/behavior and evaluate it after a few minutes and hours to see if it
can help them feel better emotionally and psychologically later on by
helping them identify better coping skills they can use in difficult future
situations, so they do not feel so overwhelmed by various factors that are
causing their stress and anxiety or depression.

e. Problem-solving and rational thinking (two-column chart).

In cognitive behavioral therapy, patients learn problem-solving methods to

feel better mentally and psychologically. In this process, the patient first
lists all the problems they are experiencing or have experienced in the past.
Next, they choose another column and list ways to solve these problems.
This helps patients identify healthy coping skills that can be used later when
they are facing similar situations in life.

f. Positive self-talk.

Positive self-talk helps patients use coping skills during stressful situations
when negative thinking may otherwise take over and cause them distress or
anxiety. For example, in cognitive behavioral therapy, the therapist will help
patients unlearn negative thoughts by helping them replace these with
positive ones so they can feel better emotionally by changing their thoughts
to become more optimistic about life issues.

g. Rehearsal.

In cognitive behavioral therapy, patients learn to change negative thought

patterns and learn new coping skills that they can use to feel better
emotionally in the future, which helps them change not only their situation
but their uncontrollable behavior.

For example, A patient may become enraged or upset by a friend who

constantly makes fun of them in front of others and even disrespects them
directly. The patient may think that this person does not like them, and they
know that the person only feels tired of being around them, so they will stop
putting up with what the other person is doing.

At this point, it is essential to help the patient take a step back and realize
that they are the ones who are having trouble with their emotions and not
the other person at all. Patients need to learn to separate their behavior
from others and be more able to identify why they feel as they do in
stressful situations to get better emotionally by changing their thought
patterns and specific aspects of their personality.

h. Relaxation techniques.

Relaxation techniques are used in cognitive behavioral therapy to help

patients feel better mentally and psychologically by developing skills they
can use to deal with stressful situations more effectively. For instance, a
person may be having problems with anxiety or depression because they
cannot focus on specific tasks when they need to due to anxiety and
depression. The patient identifies this problem and learns different ways to
relax his body physically so he can feel better emotionally by focusing on
the task at hand instead of feeling as if his mind is racing out of control.
This can be done by learning several different relaxation techniques that
help them to calm down and feel better emotionally.

i. Emotional regulation (identifying and replacing negative emotions with

positive ones).

Emotional regulation helps patients identify the source of their negative

emotions so they can learn how to manage them better when they are
having problems with anxiety or depression, and it helps them replace these
negative emotions with positive ones. For example, A patient's mother may
have died, and he feels depressed because he misses her. He has been
having trouble at home because his father scolds him for being inattentive,
but he is unaware of why he constantly feels sad. He can identify the source
of his depression, but then he must learn how to replace his sadness with
positive emotions.

The patient identifies that his father's behavior has caused him emotional
pain because he feels like the people in his life do not care about him and
treat him as if he is nothing more than an object. You can see why mental
health professionals think depression and anxiety are so important. They
help people realize that there are things they can change within themselves
so they will start to feel better emotionally by admitting their problems and
changing their thought patterns.

j. Understanding your emotions.

In cognitive behavioral therapy, patients learn to identify their feelings

about the situation at hand to learn how to change specific thoughts and
behaviors (both internal and external) that are causing them mental and
emotional pain. For example, A patient may feel sad all the time, and he
feels tired of dealing with life issues. However, he has learned that
revealing his sadness only causes people around him to feel pity for him, so
he hides his sadness by hiding his genuine emotions from others. In
addition, he has learned that keeping up with other people's lives helps him
avoid focusing on his problems by immersing himself in their lives instead of
dealing with what is happening in his own life.

This patient needs to learn how to accept his sad emotions and how to deal
with these emotions in a way that does not cause him any pain or stress. In
addition, he needs to learn the difference between letting people know that
he experiences sadness and being afraid to share his feelings because he
has learned that people will not want anything to do with him.

Cognitive behavioral therapy is effective because it helps patients learn

skills they can use when faced with stressful situations in their lives so they
can get better emotionally by learning ways to cope more effectively with
their problems.

What do the Components of CBT do for us?

The psychological components of cognitive behavioral therapy show us how

to identify what is causing us stress and unhappiness, and we can learn
skills to improve our mental health.

For instance, A patient who has suffered from anxiety or depression for a
long time may have trouble experiencing certain feelings or thoughts, so
they need to learn how to identify the source of their problems.

A patient may experience distress when his boss yells at him in front of
others because he knows that these people will gossip about him later. He
must learn to control his behavior when upset with others because he must
not act impulsively, which would cause him more stress and unhappiness. In
addition, he must learn how to cope with anxiety and depression to feel
better emotionally by thinking about his problems differently and changing
how he reacts to them.

A person who feels as if no one loves them and believes their life is
meaningless may need to learn how to develop positive thoughts and
feelings about themselves to feel better mentally. These positive thoughts
may be hard to form, but they are crucial to feeling better mentally and
emotionally.

A patient may be having problems with anger or other negative emotions

because he has learned that being angry is the best way to get his needs
met when he feels like he is not necessary at work or in his personal life.
Therefore, the patient must learn how to control his behavior to cope with
these emotions more effectively.

A person who feels as if no one understands him or cares about him may
need to learn how to develop a vision of what his life could be like if only he
had better people in it. Doing this will help him develop a better identity for
himself through creating goals for his life and a vision for his future.

A patient may have problems because they cannot focus on specific tasks at
work or in school when the time comes around, and this causes them to
have problems with anxiety and depression. The patient may need to learn
to control his behavior better to focus on the task instead of feeling like his
mind is racing out of control. He needs to learn to physically relax to feel
better emotionally by focusing on the task instead of feeling like his mind is
racing out of control.

This kind of patient needs to learn how to develop healthy self-esteem

because he believes that changing behavior based on other people's
behavior is a good way for them to feel good about themselves. Therefore,
he must learn to change this negative behavior by changing his thoughts
about himself and how he responds to others.

Cognitive behavioral therapy helps patients learn how to identify their

internal emotional problems as well as their external ones, which allows
them to develop skills for dealing better with stress, anxiety, and
depression. This is one reason why cognitive behavioral therapy is so
effective.

The last component of CBT explains an essential factor in helping us feel

better. It shows us how to eliminate our mental health problems by
identifying their causes so we can feel better mentally and emotionally by
changing our thoughts and specific aspects of our personalities to feel
better.

Therefore, Cognitive behavioral therapy can be highly effective in helping

us control our negative feelings, emotions, and moods when we deal with
them in a way that does not cause unnecessary stress. In addition, this
treatment helps patients learn about their mental health instead of just
treating their symptoms.

This kind of therapy is not invasive or painful like some other treatments. It
can benefit anyone who wants to change their behavior to feel better
emotionally. In this way, cognitive behavioral therapy is a good choice for
anyone who has not succeeded with other treatment forms.

On what basis do I decide whether CBT is suitable for me?

The basis for determining whether cognitive behavioral therapy is suitable
for a patient is to determine if the treatment can work with their specific
mental health problems.

The therapist uses general questions to help patients discover more about
their physical and emotional health. Still, deciding what treatment works
best for an individual patient depends on that patient's specific issues.

The psychologist may ask a patient how they or see him or herself
physically and in terms of personality, which will help the psychologist
provide treatment recommendations. This kind of therapist uses various
techniques to determine how best to treat patients with different mental
health issues because no two patients are alike.

A therapist will use their clinical experience to determine each patient's

best course of action. For instance, in a session, a therapist may ask about
which emotions a patient has the most problems dealing with and why.

In another session, a therapist may ask what specific events lead to certain
behaviors so that this psychologist can determine why certain behaviors are
causing problems.

In yet another session, a psychologist may ask how to deal with depression
because it is hard for the patient to think positively when he feels down on
himself, and nothing seems right in his life. The psychologist can provide
practical solutions by teaching him how to change his negative thoughts
into more positive ones so he will be happier when dealing with difficult
situations in the future.
This will help a therapist determine the treatment plan best for the patient.
A patient can also ask questions about other forms of treatment and how
they work to see if cognitive behavioral therapy is suitable for them.

For instance, an individual who does not like taking medications might feel
more comfortable with a different form of treatment. In addition, their
doctor may have some information about CBT available to help the patient
decide whether it is likely to be more effective than other forms of
treatment in dealing with his specific mental health problems.

Other patients might never ask about this treatment, but their doctors
might recommend it because it is designed to help people with various
mental health issues. However, no two patients are like the next, so one
patient may not be able to benefit from this kind of therapy if they do not
keep track of their emotions, and a therapist cannot heal other people's
problems for them.

Therefore, the doctor can only give a general recommendation as to

whether CBT will work best for a specific patient by asking questions and
discussing the patient's past experiences in dealing with their mental health
issues to find out which issues are their most significant need immediate
attention.

What about cognitive rehabilitation for those with brain injury?

Cognitive rehabilitation is the principle of helping patients with brain injury

learn how to handle and adapt to their new lifestyles after injury. In
addition, this kind of therapy helps a patient learn about his actions and the
actions of others for his good.

This therapy demonstrates that people who have experienced brain injury
have specific mental health issues. Still, in this case, their mental health
problems are caused by their changes in lifestyle after their injuries. For
instance, an individual may deal with certain aspects of brain damage
through positive thinking.

Similarly to this form of therapy, cognitive behavioral therapy can also be

used to deal with many forms of mental health problems.
Cognitive behavioral therapy can help individuals from a wide range of
backgrounds to learn how to change the activities in their lives so they do
not feel negative about themselves and thus become happier.

For instance, if an individual is dealing with anxiety or depression, they can

learn that other people have perspectives different from their own and thus
will feel better by understanding why others are thinking differently than
him.

On the other hand, understanding this kind of therapy can help an

individual deal with social situations more successfully because he will
know what he does not have control over as opposed to what he does have
control over.

To help an individual with brain injury learn this form of therapy, the
therapist can teach him to control his behaviors, so he does not have to
worry about his brain injuries and thus become happier. Furthermore, this
kind of therapy can benefit patients with various mental health problems.

For instance, to treat depression, cognitive behavior therapy will help the
patient deal with negative thoughts and emotions to feel more positive
about himself. Patients who have experienced shootings and other forms of
violence may also benefit from cognitive rehabilitation because they can
learn how to handle the situations they are dealing with.

How does CBT relate to other approaches to anxiety and depression?

Cognitive behavioral therapy is a form of psychotherapy that treats

depression, anxiety, and other mental health issues. Cognitive behavior
therapy is based on the premise that thoughts, emotions, and behaviors are
all connected.

For example, suppose a person is depressed because they recently

experienced a breakup with her boyfriend. As a result, she had to take a
new job at her company to help pay for the loss she suffered with their
relationship. In that case, the therapist will help her learn how to deal with
these problems by changing how she feels about them.
The therapist will first assess the patient's feelings to determine precisely
what is causing their negative emotions by asking open-ended questions
about what makes him feel sad or angry.

The patient will then learn how to take control of his emotions by practicing
specific exercises, such as cognitive restructuring, which is the modification
of negative thoughts to make them more positive to change how a person
feels about himself.

For example, suppose a patient feels depressed after a breakup with his
boyfriend and feels his life has no direction or purpose. In that case, the
therapist may help him learn how to deal with this by reminding him that he
has made mistakes along the way despite his successes.

The patient will repeat these positive and realistic statements until these
thoughts become habitual within his mind and he can feel better about
himself.

As another example, if a person has an anxiety attack after experiencing

criticism from a coworker, the therapist will help him feel more confident by
trying to change his thoughts to make him feel like he can deal with the
critique.

Similarly, cognitive behavioral therapists will also learn how to motivate

their patients by providing them with resources that help them learn how to
deal with their mental health issues and the tools they need to overcome
those issues.

The therapist's goal is generally to teach patients how they can control their
emotions and behavior to overcome obstacles in their lives. For example,
cognitive behavioral therapy treats various mental health issues, including
anxiety, depression, eating disorders, and other forms of aggressive
behavior. This kind of therapy is particularly effective when used to treat
addictions because the patient is given a safe environment in which he can
learn how to control his actions.

Cognitive behavior therapy has also been effective in treating PTSD because
it helps patients deal with trauma by allowing them to understand that they
have had some control over the events that have occurred in their lives, so
they do not need to worry about these events and become stress about
dealing with those issues. Furthermore, it has been proven that CBT is more
cost-effective than many traditional therapeutic approaches.
 Principles and characteristics of CBT
Cognitive behavior therapy (CBT) is an evidence-based psychological
treatment that aims to help people who have problems with anxiety,
depression, addiction, and other mental health problems. It focuses on how
patterns of thoughts and behaviors affect emotions and moods. CBT also has
a strong emphasis on the development of practical coping skills to reduce
the impact of these maladaptive thoughts and behaviors.

CBT is a ‘talk therapy in various settings, including doctors’ surgeries,

hospital outpatient departments, counseling, and community health
services, and can be delivered by several professional practitioners.

This therapy has several principles and characteristics that differentiate it

from other psychotherapies. Moreover, this therapy reaches people who
need to use their initiative to make changes in their lives necessary for
recovery, rather than doing things ‘on the list. CBT involves the active
participation of patients in their treatment and is focused on facilitating
self-management of symptoms and recovery.

CBT integrates, improves, and focuses on the patient's present functioning

(across all domains) and does not focus on past events or future forecasts.
In addition, it strongly emphasizes being outcome-based (aiming for positive
outcomes) instead of behavior-based (targeting negative behavior). This is
because it believes that change happens only when patients desire it.

Principles of CBT
These CBT principles have been the subject of many empirical studies in
recent decades. The contributions of the principles to therapeutic outcomes
have been found to vary across disorders, patients, therapist styles, and
different types of therapy. However, there has been agreement that these
principles are essential ingredients in a CBT model.

The effectiveness of CBT relates to an active collaboration between

therapist and client. The goal is not simply to provide advice or insight but
to help patients work through their problems by facing their fears. This is
accomplished by developing personal coping strategies through exercises
that enhance personal control and responsibility over one’s life.
CBT-based interventions are structured, goal-oriented, and collaboratively
developed by the patient and the therapist. CBT can be delivered in various
modalities—individually, face to face, via computer, telephone, or
videoconferences.

CBT has clinical applications for patients with chronic or severe mental
disorders, including major depression, anxiety disorders, eating disorders,
substance abuse disorders, and personality disorders.

The principles of CBT (with some differences) are used to treat non-
psychiatric problems such as weight loss and relationship difficulties. In
recent years CBT has been applied to a wide range of physical illnesses
such as diabetes mellitus, chronic pain, cancer recovery, heart disease, and
irritable bowel syndrome. There is also increasing evidence that it can play
a role in treating chronic diseases (such as asthma).

The Cognitive model emphasizes an understanding of how an individual's

thoughts affect one's emotions and behavior. It views thoughts as a chain
reaction relating to feelings, resulting in different actions. In general terms,
negative thoughts lead to negative feelings, which lead to negative actions
and outcomes.

Psychotherapy is a unique intervention because the therapist (together with

the patient) directly engages in cognitive and behavioral activities that
focus on changing maladaptive patterns of thinking and behaving. This
process often occurs within a particular therapy setting that emphasizes
personal attention, active listening, and the use of behavioral techniques for
change.

Instead of simply talking to patients about their problems, CBT therapists

will often request specific behaviors, which are considered homework or
even ask patients to experiment with new coping skills. For example, many
CBT therapists ask their patients to try using relaxation techniques such as
deep breathing before an upcoming stressful situation or even in the middle
of the day just before a challenging task at work.

The principles of CBT include:

1. Self-management of symptoms – CBT focuses on personal changes of
behavior that help control and reduce the impact of emotional reactions in
situations that can trigger anxiety or depression. The goal is to achieve a
level of comfort, relaxation, hope, and optimism during challenging
situations that would not otherwise be present.

2. Client-directed therapy—Therapy sessions are developed in collaboration

with the client based on the patient’s individual needs and issues rather
than according to a preconceived plan. This technique focuses on how a
particular session can benefit both parties. They will also focus on making
the best use of their time together by developing strategies to keep clients
engaged and interested throughout counseling sessions.

3. Collaborative and work-focused relationship – CBT therapists believe that

change is most effective when clients feel comfortable and willing to
experiment with new ideas or ways of doing things. The therapist's goal is
to have patients actively participate in their treatment to create a
“cooperative therapeutic alliance.” The therapist will often work with
clients to develop specific goals and agree on techniques for working
towards those goals.

4. Self-discovery – CBT helps individuals recognize patterns of thinking and

behavior that trigger feelings of anxiety or depression while also exploring
factors that may contribute to these conditions, such as childhood
experiences, personality traits, social support systems, and other
environmental variables. As a result, CBT clients can develop more realistic
and practical coping skills by better understanding these behaviors.

5. Mindfulness – The principle of mindfulness is often used as a component

technique for reducing anxiety or stress. It involves focusing on one’s
perceptions, emotions, thoughts, and behaviors in a non-judgmental way
that helps individuals become more aware of their current state of being.
Within this technique, it is often helpful to observe various patterns in one's
life and then notice what thoughts are associated with them and how they
alter feelings or behaviors.

6. Striving for success – CBT teaches clients how to overcome their

emotional difficulties. They are encouraged to explore their options and use
specific skills and techniques to cope with anxiety or depression. These
strategies can include:

1) Relaxation techniques such as breathing or meditation

2) Plain, everyday activities that can be used simultaneously with one's

usual activities, such as giving up watching television instead of going home
early

3) Imagination exercises, such as focusing on positive thoughts during

difficult situations or using an optimistic self-talk

7. Reciprocal reinforcement – CBT therapists often request that clients

actively attempt new coping skills rather than simply listening to the
therapist and accepting one’s diagnosis and treatments. The therapist will
explain how coping techniques work and will often provide immediate
feedback on whether or not clients are responding appropriately. CBT
therapists will also request that clients make a conscious effort to
acknowledge and reward themselves for their successes at specific tasks,
such as being able to remain calm during a stressful situation.

8. Problem-focused coping – CBT is known for dealing with specific

problems or issues in one's life, such as difficulty sleeping, relationship
difficulties, chronic pain, self-esteem issues, and work-related stress.

9. Relaxation techniques – There are many relaxation methods in CBT,

including meditation, guided imagery, and progressive muscle relaxation.
These tools are often used during stress to help reduce anxiety while
developing other coping skills.

Common cognitive distortions include:

a. All-or-nothing thinking – This type of thinking tends to exaggerate the

reality of a situation by viewing things in absolutes. The individual will think
that something is either good or bad rather than have the ability to
appreciate both the positives and negatives of a particular situation.

b. Overgeneralizing – This type of thinking occurs when individuals view

adverse events as indicative of a more significant problem without
recognizing other factors that may not be related to the targeted event. For
example, a person may start to believe that they are completely
incompetent, even though there is evidence that some regions of their life
are not affected by these poor skills.

c. Mental filter – This type of thinking leads individuals to focus on and

amplify only certain aspects of a negative situation without considering the
fullness of the context. For example, a person may focus on the one task or
aspect that they performed poorly during the day but ignore all other
positive events or completed tasks.

d. Disqualifying the Positive - This occurs when individuals accept positive

experiences as accurate (or valid) but qualify them with negative thoughts
and feelings to remove their validity. For instance, if a person feels they are
a valued family member, they may still find a way to disqualify this positive
experience by believing their parents only wish for them to keep them
company.

e. Jumping to Conclusions – This occurs when individuals make assumptions

about other people, situations, and events without concrete facts. For
example, an individual may believe that a friend's lack of response to an
email is due to anger before trying to check in with their friend.

f. Magnification and Minimization – These distortions involve exaggerating

the severity of negative events or minimizing the value of positive
experiences. For example, a person may expect to fail at a task and dwell on
how they will be embarrassed if they do so, thus magnifying the negative
experience. Alternatively, people may find ways to minimize their positive
experiences by assuming that others are not impressed by the same
accomplishment or event.

g. Personalization – This type of cognitive distortion occurs when individuals

believe that things that happen are directly linked to them or their behavior
when there is no evidence to back up these claims.

h. Labeling – This occurs when individuals place a negative label on

themselves without considering that other people may not view them the
same way. For example, a person may believe that their personality is so
unique and different from others that they will be considered rude even if
they do not mean to be.
i. Catastrophizing – This distortion involves assuming catastrophic outcomes
when a situation is perceived as more complicated than it is by including
extreme possibilities based on one's fears and expectations.

10. Problem-solving

a. Cognitive restructuring – This technique involves individuals recalling

and challenging distorted thoughts to help them adopt a more realistic
perspective. For example, if an individual believes that everyone will be
upset if they admit to having anxiety and anxiety symptoms, cognitive
restructuring can focus on the fact that other people may not share this
assumption. But even if they do, the individual can still benefit from taking
action while open to new possibilities. For example, an individual may
believe their coworkers will discover their disability and fire them for being
on medication for anxiety or depression. However, cognitive restructuring
can focus on the fact that this is an unlikely scenario and that one must still
accept that coworkers may be frustrated instead.

b. Cognitive coping – This coping focuses on placing oneself in a better

position to handle negative events by finding ways to make these situations
less stressful. For instance, if a person believes that other people will think
they are lazy, cognitive coping can help the individual focus on being more
productive and putting forth effort throughout the day so as not to be
confused with a person who is not willing to work as hard.

c. Changing perspectives – When individuals feel trapped and unable to

control their lives, they may become paralyzed by overwhelming feelings of
anxiety and depression. Changing perspectives allows people to feel in
control and take positive steps towards their goals by challenging negative
thoughts and assumptions about themselves. For instance, individuals who
have problems with their health may adopt different perspectives around
their negative thoughts about being unable or unwilling to take care of
themselves. Individuals can be more proactive in navigating difficult
situations by changing their focus from caring for themselves to caring for
their family or helping others.

d. Active role – To find ways to break negative cycles and cope with
distressing situations, individuals must take an active role in their recovery.
For example, by focusing on how one can approach challenging situations
instead of engaging in problem-solving based on how one can cope with
negative outcomes, individuals can focus on more positive and effective
methods. e. Positive self-talk – This type of coping focuses on believing in a
positive outcome and repeating positive thoughts to keep one's spirits up.

11. Interpersonal effectiveness

a. Social support – This type of coping involves having others in one's life
that can provide emotional support and help more effectively manage
thoughts, feelings, and behaviors that may become problematic. For
example, suppose an individual is not feeling well but does not know how to
reach out for emotional support. In that case, other people in their life may
be able to provide helpful resources or personal connections without trying
to fix them or make them feel better.

b. Problem-solving – This refers to how one can approach distressing

situations that may otherwise become overwhelming. For example, suppose
individuals are having trouble socializing with others. In that case, problem-
solving can help them identify and tackle the issues that may influence their
behavior in these settings and provide better solutions for communicating
with others more healthily.

c. Communication – This type of coping relates to how one communicates

with others and helps them better understand challenging situations in their
lives and themselves. When individuals can communicate effectively with
other people, they may feel less isolated and more supported when they
face difficulties.

CBT was initially developed by psychiatrist Aaron Beck in the 1960s

through the 1970s through his pioneering studies on depression and anxiety
disorders. He also developed cognitive therapy, which deals primarily with
thoughts, helping people change the way they think to overcome negative
self-beliefs such as negative cognitions and dysfunctional beliefs.

Some CBT approaches use a “Cognitive Therapy” technique that alters

one's thinking patterns. On the other hand, other approaches use
“Behavioural Therapy” as a guiding principle of treatment.
CBT practitioners typically work within a different setting than medical
doctors, who are trained to diagnose and treat mental disorders solely by
medications. CBT therapists believe that people can deal with their feelings
and problems by taking an active approach to suffering through different
strategies that can be learned within the therapy sessions.

These principles are essential since:

a. CBT is considered more effective than other psychotherapies, with most

patients receiving positive results as long as they are willing to work and be
active in the therapy process.

b. CBT is available in various formats and types, including individual

sessions, group therapy, self-help books, computer programs, and Internet
applications.

c. CBT mainly focuses on patients’ participation to help them take an active

role in their treatment.

d. CBT can be used with medications and other treatment modalities, such
as traditional psychotherapy or behavioral techniques.

e. CBT does not require patients to address their early experiences, which is
a common framework for other types of therapy.

f. CBT is cost-effective since psychiatric hospital stays and physician visits

are unnecessary for this type of treatment.

g. Recent studies have suggested that some forms of CBT may positively
affect patients with schizophrenia or obsessive-compulsive disorder (OCD).

h. CBT therapy is typically shorter than other types of psychotherapy, such

as psychoanalysis, since it often takes less time to achieve results than more
traditional treatments.

i. CBT is more effective at treating anxiety disorders than other types of

psychotherapy.

j. CBT is often used to help patients deal with various life issues, including
depression and panic disorder, eating disorders, alcohol abuse, and
substance abuse.
CBT is sometimes used with medications to treat severe mental illnesses
such as bipolar disorder or severe depression. In some cases, it replaced
medication altogether.

CBT can also be used to improve skills in dealing with anxiety/ stress
reactions, child/ adolescent counseling, couple's therapy, and family
therapy. CBT has been proven effective in treating most types of mental
health disorders.

CBT Characteristics
CBT has several characteristics. These are also essential since:

a. CBT is considered an effective form of psychotherapy, with most patients

who undergo this type of treatment showing noticeable improvements.

b. CBT is a short-term therapy that takes about 12–15 weekly, depending on

the patient's specific needs and goals.

c. CBT has been proven effective in treating anxiety disorders, depression,

and other mental illnesses.

d. The right combination of CBT principles, psychology, and social work

techniques can effectively treat any mental health disorder.

e. In most cases, patients don't require medications or hospitalization while

they undergo this type of therapy to help them overcome their issues and
improve their well-being over time.

f. CBT is cost-effective since the therapist helps patients identify their

problems and implement solutions to manage their symptoms within a short
period.

g. CBT is based on scientific evidence and practice, making it a more

reliable approach to help people overcome different issues.

h. CBT works well with other forms of treatment, such as medication or

dietary changes, because this approach may combine different techniques
to provide better patient outcomes.
i. Generally, CBT can be implemented in various settings and formats, such
as individual therapy sessions, group sessions, phone sessions, or online
counseling (e-therapy).

Therefore, some of the characteristics of CBT are explained below:

1. It is time-limited than other therapies

CBT is a time-limited therapy. Therefore, patients need to identify the

reasons why they need clinical treatment and the goals they want to
achieve. Thus, CBT therapists and patients work together to develop
appropriate psychotherapeutic treatment strategies to apply certain CBT
techniques within a specific period.

2. It focuses on changing current ways of dealing with problems and

incorporates other types of therapies

CBT makes patients aware of their options for dealing with or solving issues
in their lives by changing how they respond to specific situations.

CBT does not always work alone. Some patients may have to combine CBT
concepts with other forms of psychotherapy, such as interpersonal therapy,
family therapy, or dialectical behavior therapy (DBT).

3. It is based on scientific evidence and realistic practice

Most CBT techniques have been proven effective in clinical trials and
research studies. On the other hand, CBT practitioners are well-educated
professionals trained to help patients overcome their mental health issues
through different therapeutic interventions based on scientific evidence.

4. It is cost-effective

Since most CBT therapies can be implemented within a short period, this
type of treatment tends to be more cost-effective than some traditional
approaches.

5. It is based on cooperation and collaboration between patients and their

therapists

Patients are expected to be active in the therapy process by taking an active

role in the treatment. Therefore, patients should have good communication
skills that help them express their feelings, thoughts, experiences, or other
issues they want to change over time. In some cases, it may be helpful for
patients to keep a journal or record their thoughts and feelings on different
situations that affect their mental health status during the CBT treatment
period.

6. It can be used in various settings

CBT can be applied in different settings, such as individual, group, face-to-

face, or phone sessions. It can also be used to treat patients with various
mental health disorders alone or in combination with other therapies.

7. It helps patients identify and deal with their emotions and other
psychological factors

CBT helps patients identify the negative thoughts or beliefs that affect their
coping mechanisms and make managing their symptoms difficult. For
instance, some people may feel upset because they tend to feel guilty when
they make a mistake at work or home. Other individuals may become
anxious when faced with specific situations because they create negative
interpretations (i.e., "I failed this time, and it will happen again").

8. It helps patients develop more effective ways to handle stressful

situations

During the CBT treatment process, patients learn how to control their
thoughts, behaviors, and emotions to manage stress levels better. Some of
these skills are useful for managing specific mental health disorders after
completing their sessions.

9. It is a short-term therapy

Most CBT programs last for about 19 to 21 weeks. However, there are some
cases where people may benefit from more extended treatment periods
(such as one or two years). The length of CBT programs depends on the
patient's specific needs and goals.

10. It is a combination approach

CBT involves different types of therapeutic techniques that can make it

more effective than the use of single techniques on their own. For instance,
CBT practitioners will help patients explore relevant emotional issues, such
as suicidal thoughts and feelings, and address other emotional sources
based on their assessments and observations over time.

11. It can be used to treat several mental health disorders

CBT has been proven effective for various mental health disorders such as
depression, anxiety, panic disorder, eating disorders, post-traumatic stress
disorder (PTSD), social anxiety, and addictions such as alcohol addiction
and substance abuse. CBT is a few psychotherapies considered a first-line
treatment option for patients with major depressive disorder (MDD).

12. It is used together with other evidence-based treatments

Although CBT is highly effective, it may be combined with other therapies to

improve patient outcomes. For instance, patients struggling with anxiety
may benefit from using CBT combined with exposure-based interventions,
such as imaginal desensitization and relaxation (IDR). Some patients may
also benefit from using DBT, a cognitive behavior therapy performed online
and face-to-face. These therapies can be combined with medication to
increase treatment effectiveness and reduce the risk of other side effects.

13. It helps patients deal with their unwanted thoughts and emotions

CBT can also help patients develop ways to deal with their unwanted
thoughts and feelings. The therapist will help them explore why they tend to
experience particular negative or unpleasant feelings in specific situations,
such as episodes of intense depression, anxiety, or anger over time.

14. It can be applied to a wide range of different populations

Some CBT programs are gender-specific such as the Heidelberg Cope

Program for men, which focuses on issues unique to men, such as alcohol
dependency and relationship concerns, while others (such as DBT) are
designed for women.

15. It can reduce the risk of relapse

CBT has been proven effective in preventing people from relapsing into
depressive or anxiety disorders. Based on the research presented in several
CBT studies, reduced symptoms and improved overall functioning are
associated with an increased chance of treatment dropout among patients
who do not adhere to their treatment protocols.

16. It is more effective than some other therapies

CBT is generally considered one of the most effective non-pharmacological

treatments available today. It also has fewer risks than medication and
other standard therapies used for treating major mental health issues over
time.

Adjunctive Interventions

Education

There is evidence that CBT can be effectively delivered to groups of patients

in educational environments to spread the skill set and make them available
to more people. Several E-learning platforms provide online CBT, making
this delivery method more accessible and affordable. These online resources
provide a cost-effective way of disseminating CBT skills worldwide.

Self-help Books

CBT self-help books are used as an adjunct to other forms of therapy or by

individuals wishing to address particular issues for themselves without
being seen by a therapist. These books allow the reader to work through the
material at their own pace and have the added benefit of being relatively
inexpensive. Books can be purchased online or at local bookstores.

CBT in Schools

CBT is being used increasingly in schools to teach children how to deal with
various issues, such as anger management, social skills, and emotional
intelligence. It is becoming a standard part of the curriculum in schools
nationwide. The use of CBT and other methods is increasing, and many
teachers are now trained specifically to deliver this treatment when it's
required.

Inpatient Rehabilitation Programs

CBT in acute care rehab programs for patients suffering from depression or
anxiety disorders has been proven effective for reducing symptoms and
improving functioning and quality of life. In addition, this approach is
inexpensive and effectively reduces recidivism rates by allowing patients to
address their issues while under close supervision.

Online CBT Programs

CBT is now being delivered using a variety of online platforms. These

programs blend face-to-face therapy, video conferencing, and internet
exposure techniques. Sometimes, the therapist will be local and available
for a phone or Skype session whenever required. The patient can work
through the material at their own pace, and the online program will
automatically score them after each step so they can see where they are in
the process at any time. This type of approach has the advantage of being
relatively inexpensive and allows access to the therapist at any time.

CBT in Public Settings

CBT is now offered in public settings such as daycare centers, rehabilitation

centers, prisons, and community mental health clinics. CBT works best
when delivered to large groups of patients at once. This was first done by
the Beck Institute in California and has now been expanded to many other
countries worldwide. This method has also been proven effective in
reducing recidivism by allowing patients to work through their issues under
close supervision.

Parent-Child Relationship Therapy

A form of a family program initially developed by John Gottman, this

therapy focuses on improving communication between parents and their
children. It seeks to help parents understand their child's emotional needs,
set clear boundaries regarding this behavior, improve communication skills
and establish an emotional connection at home. The program also seeks to
teach children fundamental skills for communicating effectively and
appropriately, such as giving feedback, apologizing for mistakes, and
accepting criticism.

A recent study has shown that the program can be used in the online
environment to treat children with social anxiety issues. The program is
designed for parents and children and uses a series of exercises to
strengthen family relationships.
Cognitive behavioral therapy is based on a theory of maladaptive learning.
It suggests that maladaptive behavior patterns are no more than faulty
associations automatically learned by individuals as they cope with their
day-to-day life experiences as they age. CBT aims to identify these patterns
and provide strategies to change them into adaptive, healthy, productive
behaviors and thoughts.

Many different therapies have used elements of CBT, but they are often not
included in the therapeutic manual. Some examples of therapies that
include cognitive behavioral therapy are rational emotive behavioral
therapy, rational behavior therapy, cognitive integration, acceptance and
commitment therapy, dialectic behavior therapy, and more. Cognitive
Behavior Therapy differs from other types of psychotherapy because it
focuses on the present behavior rather than the client's past experiences.

Cognitive Behavioral Therapy has been used to treat children as young as

five. It was thought to be well suited for them because it was
straightforward and practical. This treatment aims to change specific
thought patterns and create healthier relationships among family members
or peers.

There are several groups of cognitive distortions that CBT focuses on

changing. They include:

CBT attempts to rewire the person's negative thinking style by providing

them with strategies to identify and re-evaluate their negative biases and
assumptions. Therefore, CBT aims to have a client or patient accept things
and then make informed decisions rather than fall back on the inaccurate
information they had previously.

Behavioral activation is often used to treat depression, anxiety, and phobias

such as agoraphobia by encouraging clients and patients with these issues
to engage in behaviors related to avoidance.

CBT Theory

Many therapists use CBT for conditions other than depression, anxiety, and
phobias. CBT is a helpful treatment for many psychological disorders, but
its specificity makes it most appropriate for treating depression and anxiety.
This is because most forms of CBT are based on the theory of cognitive
therapy and subsequent assumptions about depression and anxiety.

Similarly, to Beck's model, most modern CBT theories are based on the
assumption that depression and anxiety result from negative thoughts about
the self or others; what we think about ourselves or others can, in turn, lead
to unhealthy thoughts and behaviors. For example, the belief that one is not
good enough to get a job causes a person to think and act in ways that
prevent them from getting the job. This culminates in feelings of depression
and anxiety. The opposite applies if the person believes they are good
enough for the job: a healthy set of thoughts and behaviors results in
positive outcomes, preventing feelings of depression and anxiety.

CBT emphasizes how these thoughts lead to unhealthy behaviors. Still, it

also allows therapists to examine dysfunctional emotions, which are
negative emotions resulting from a thought process. This assumption allows
CBT theories to distinguish between different types of depression and
anxiety disorders and individuals with both types of disorders
simultaneously.

CBT is a set of cognitive behavioral strategies that attempts to change

dysfunctional thoughts and behaviors. To do this, therapists must use
positive interventions and strategies (such as focusing on the present) while
also being able to challenge dysfunctional thoughts and emotions.

Therapists believe that depression and anxiety result from negative

thoughts about the self or others, which can lead people to act in unhealthy
ways. Therapists are there to help patients identify these negative thoughts,
evaluate them accurately, clarify the truthfulness of their beliefs, and
replace them with healthy alternatives. These adaptive thoughts can then
guide decisions about treatment options, decreasing feelings of depression
or anxiety.

CBT is based on the cognitive model of emotional distress. This model

consists of several interconnected components: the target (or client or
patient), the event (sometimes called "stimulus"), the thoughts that follow,
the feelings, and finally, behavior. The diagram below depicts this
relationship.
CBT Practice

Many different therapies have used elements of CBT, but they are often not
included in the therapeutic manual. Some examples of therapies that
include cognitive behavioral therapy are rational emotive behavioral
therapy, rational behavior therapy, cognitive integration, acceptance and
commitment therapy, dialectic behavior therapy, and more. Cognitive
Behavior Therapy differs from other types of psychotherapy because it
focuses on the present behavior rather than the client's past experiences.

Basic assumptions or beliefs that comprise a large part of CBT theories

make diagnoses more specific to certain disorders. This is important for
therapists to consider when deciding which model to use in their case. In
addition, CBT requires therapists to be able to make distinctions between
several different types of depression and anxiety disorders.

Depression is a mental disorder in which people experience low mood

(depressed), an inability to experience pleasure or both. Some people with
depression may also have feelings of guilt, worthlessness, hopelessness, and
suicidal thoughts. Common symptoms include anhedonia (lack of interest in
enjoyable activities), problems with concentration and sleep, poor appetite,
fatigue, or weight loss.

Constant sadness or hopelessness are associated with anxiety disorders.

This includes an intense fear of anxiety ("Fear," panic attack), leading to an
avoidance of anxiety-provoking situations ("Flight" response) and results in
excessive worry ("Rumination" response).
 CBT interventions
Cognitive Behavior Therapy is a type of psychotherapy developed to help
people with various mental health disorders. It uses cognitive processes,
such as thoughts and behaviors, to help change the way one's brain
functions. This therapy has been proven effective for treating people
suffering from anxiety, depression, insomnia, and panic disorders. In this
book, we'll discuss how CBT interventions work to treat these conditions.

CBT interventions are often used for treating patients with mental health
conditions such as anxiety disorders and depression by helping them
become more aware of their negative and potentially destructive thoughts,
which lead them towards emotions like fear or sadness. These interventions
aim to replace these negative thought patterns with positive and
constructive beliefs.

One of the most common CBT interventions is Cognitive Reframing, which

involves examining their thoughts, feelings and negative behavior patterns
to acknowledge them and then change them if necessary.

In some cases, Cognitive Behaviour Therapy may be used in conjunction

with medications for treating mental health conditions such as depression
as a stand-alone treatment or with traditional psychotherapy. However, it's
essential that any woman who is pregnant, nursing, or thinking about
becoming pregnant speak to her doctor before taking any medication.

Cognitive behavior therapy aims to help people with mental health

conditions to recognize their negative thinking patterns and to see how
those patterns directly influence their behavior and emotional state. For
example, a person suffering from panic attacks might acknowledge that
they tend to view even small physical sensations as dangerous; by
practicing relaxation techniques, they may be able to re-train themselves
from this negative thinking pattern. The goal, in general terms, is for people
undergoing cognitive behavior therapy to learn more constructive ways of
thinking about things and behaving. CBT interventions are most effective at
treating patients with mental health conditions when the treatment is
comprehensive.
 What are Cognitive Behavioral interventions?
Cognitive behavioral interventions are a treatment system that focuses on
helping people with mental health disorders change their behaviors and
emotions by changing their internal thoughts. In CBT, we try to make the
changes that would benefit your mental state, even if they don't seem
evident at the time.

We used several methods, including prompts, self-help exercises, behavioral

experiments, and thought records. These are all ways we can help you look
more carefully at where your thoughts and behaviors are coming from so
you can address them more effectively in the future.

Hopefully, with some guidance, you will be able to learn what to focus on
and change to make your life better. Depending on your response, we may
use several different CBT interventions or treatments for the same
condition.

CBT interventions are used for many different purposes. The primary ones
are self-help, promoting a more positive outlook, and helping with emotional
well-being and behavior modification.

Cognitive behavioral therapy effectively treats anxiety disorders such as

social anxiety, panic attacks, OCD, phobias, and post-traumatic stress
disorder. It is also commonly used to treat depression, particularly in
women during pregnancy and postpartum. However, it should be noted that
CBT interventions do not work for everyone with these disorders. Still, it
can be tremendously helpful for people without immediate access to
therapy or medication.

CBT interventions include:

1. Thought records

A thought record is a tool designed to help you recognize your negative

thinking patterns so that you can change them. You will be asked to record
how you are feeling and what you are thinking about. This may seem like a
simple task, but it can be difficult when we don't see our negative thoughts
as problems or believe that those thoughts are ok. Thoughts should ideally
not be treated like beliefs or facts but instead looked at and assessed for
false, misleading, or distorted information.

With some practice, making a thought record may feel awkward at first, but
after gaining some experience, it can become somewhat natural and
enjoyable. Thought records may also be used to help you focus on the
positive aspects of your life by recognizing and recording what you're
feeling and thinking about. Thought records can be used for a variety of
situations and purposes, such as:

a) How you feel about yourself or your life

b) Your relationship with others

c) Your religious, spiritual, or personal beliefs

d) What kinds of things make you feel the way you do?

2. The negative assumptions worksheet

In this worksheet, we will ask you to write down as many negative

assumptions or expectations as you have about yourself and your life. These
are things that you believe to be facts about yourself or others, even though
they might not be accurate.

When doing the negative assumptions worksheet, most people have more
difficulty with the positive listing of expectations, which is just as important.
Therefore, when first completing this worksheet, it is a good idea to take
your time, write down what you come up with, and don't be discouraged if it
takes a few efforts before you feel like you've covered all of them. Moreover,
once you've completed the worksheet, it is essential not to skip over any
lines - instead, keep filling out the sheet.

3. Thought records manipulation

A thought record manipulation is designed to help you identify negative or

generally unhelpful thoughts and patterns. For example, you may have
some negative beliefs about yourself or others even though they are not
true, and when these beliefs are set in stone, they can be challenging to
change. For this kind of intervention to be effective in helping you alter your
negative thinking patterns, you must recognize and acknowledge them.
For this reason, you are asked to think about a specific problem and write
down your thoughts and feelings about it. The thought record manipulation
helps you look at this information and put it into perspective to develop a
more productive way of thinking.

4. The ABC worksheet

The ABC worksheet is designed to help you identify what happens when you
have certain emotions or moods. When we experience an emotion or feeling,
we tend to attribute the emotion to something in particular. When we feel
angry, for example, it may be because someone said something rude or
because of some other outside stimulus; similarly, when we feel anxious or
stressed out, it is often attributed to some environmental factor.

The ABC worksheet helps you to identify what makes you angry, anxious, or
sad and why. These facts can be used to help you alter your moods or
reactions in a healthy way so that they will not affect your everyday life in
the way they do now.

5. The relaxation response and breathing meditation

By learning to control your breathing, you can relax and calm down, even if
you are having a difficult time doing so at the moment. The relaxation
response is a state of deep relaxation achieved by short periods of
controlled breathing.

Breathing more effectively can help us decrease physical and mental stress
levels. Various breathing exercises help improve sleep, reduce pain, and
ease feelings of anxiousness. These techniques include diaphragmatic
breathing and tummo (Tibetan yoga breath).

6. Metacognitive therapy

Metacognitive therapy (MCT) is a form of CBT concerned with how people

think about their thinking. It is a popular treatment used primarily for
anxiety disorders, but it can also be used for other conditions. For example,
a person suffering from an anxiety disorder tends to worry excessively
about what they believe could go wrong in their life. Even though some
people may be more naturally prone to having these thoughts than others, a
person can develop them through life experiences.
MCT helps people with anxiety disorders to understand how their current
behaviors and fears prevent them from leading healthy, productive lives. As
a result, it can help people reduce the intensity of their anxiety, learn how
to relax, and handle stress in more productive ways. MCT also helps the
person recognize that they are not alone in thinking these thoughts, that
they are common and other people have them too; this realization often
helps individuals feel less isolated and therefore less depressed or anxious.

7. Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a treatment that is effective in

treating many psychological conditions. CBT aims to provide people with a
way of thinking about the problems in their lives that will help them
progress towards their goals, no matter how large, small or irrelevant they
may seem.

In CBT, people are encouraged to recognize and acknowledge disturbing

thoughts and beliefs to learn how to imagine different scenarios and how
they might affect their lives. This helps people identify situations in which
they might otherwise be anxious or stressed so that they are more likely to
cope with them by trying new coping strategies instead of taking on
unwanted behavior.

8. Mindfulness and acceptance

Mindfulness and acceptance are two common approaches to CBT that are
also used to treat several psychological disorders. The purpose of
mindfulness is to help people become more aware of how they react to their
thoughts and feelings and stop identifying these reactions as being outside
their control. For example, if you feel anxious about speaking in front of an
audience, this anxiety may result from an issue with your self-confidence or
performance, but you might see this feeling as your fault. The idea is that
the more you become aware of these reactions, the less they will influence
your behavior.

With acceptance, people are taught to accept their thoughts and feelings
instead of trying to change them. This approach can be helpful for people
with anxiety disorders who are bothered by a constant flow of intrusive
thoughts. The idea is that the more you practice accepting these thoughts,
the less they will bother you.

9. Cognitive therapies

Cognitive therapy seeks to help individuals change their thought processes

to form more rational and realistic beliefs about their lives and the future.
This typically involves learning how to use your memory well to recognize
distorted or mistaken information you may have been receiving.

The goal of cognitive therapy is to help people learn how to focus their
attention on events that are important to them and those that are not. For
example, a person with an anxiety disorder might focus on the thoughts and
feelings they associate with worrying about something happening in their
lives, when there is nothing of importance to worry about. Unfortunately,
this distraction from more essential hassles prevents people from focusing
on more positive aspects of their lives.

Cognitive therapy can also help people make more effective judgments
about the future by helping them become aware of how they think about
events in their past and present.

10. Psychodynamic therapy

Psychodynamic therapy focuses on improving a person's sense of well-being

by teaching them how to make the most of their inner resources and
strengths instead of focusing on their weaknesses. This approach is often
used for people who feel anxious about things that are out of their
immediate control, such as people who are afraid of contracting HIV or
other infectious diseases or a person who feels uncomfortable going out to
meet new people because they do not know how to behave in social
situations.

This treatment teaches people that specific thoughts and feelings are
irrational and harmful, but they tend to experience them anyway. In
addition, this approach helps change how these thoughts come to be or
create new ways of reassuring themselves that they are not as stressed or
upset as they are experiencing.

11. Rational emotive therapy

Rational emotive therapy (RET) focuses on helping people with frightening
thoughts and feelings by helping them challenge their negative beliefs
about the situations that cause them to fear. This approach has been used
successfully with various anxiety disorders, such as phobias, panic attacks
and PTSD, because it helps people understand that their irrational fears do
not have to be true for them to feel anxious and stressed.

RET aims to help people become more self-aware and recognize the
irrational thoughts they have that cause their anxiety in the first place. This
approach is beneficial for people who tend to be extra cautious about
controlling the situations that make them worried or anxious.

12. Experiential therapy

Experiential therapy, also called exposure therapy, helps people learn how
to tolerate the things they fear without succumbing to them. This treatment
is beneficial for people with phobias who fear certain situations or objects,
such as a person who is afraid of dogs or a spider; it can also be used for
those afraid of heights, enclosed spaces, or flying.

This type of therapy focuses on exposing people to the type of situations

they fear as often as they feel they can handle them. For example, if a
person is afraid of dogs and is struggling to walk by one, they may be
required to walk by a dog on their way to work slowly. If this causes
anxiety, they could be taught to walk through the dog in question and keep
walking.

13. Acceptance and commitment to therapy

Acceptance and commitment therapy (ACT) takes a more direct approach to

examining how people react when confronted with troubling thoughts that
normally trigger their anxiety. This therapy is particularly useful for those
who feel overwhelmed by guilt or shame but struggle to actively express
these emotions to others.

ACT encourages people with anxiety disorders and phobias to think about
situations that give rise to the feelings of guilt or shame they are
experiencing. This approach helps them work through the thoughts that
cause their anxiety and change how they express these emotions.
14. Dialectics

Dialectics is a branch of learning theory that teaches people how to learn

better by actively engaging in dialogue with others. This approach identifies
ways in which people can challenge their ideas by first becoming aware of
why they feel the way they do about certain subjects.

Dialectics helps people recognize and become aware of the various

emotional and cognitive processes that cause them to be stressed when
faced with certain situations or events. By recognizing these thoughts,
people can identify situations that cause them stress and then decide
whether or not they are worth worrying about.

15. Transcendental meditation

Transcendental meditation (TM) is a unique form of treatment that uses a

series of words known as mantras while sitting in a comfortable position to
help you achieve complete mental stillness. This program works by using
positive affirmations or thoughts that can be said to oneself to improve your
state of mind and remind you of a beneficial feeling or situation.

Though there are some similarities between transcendental meditation and

other therapy programs, such as Cognitive Behavioral Therapy and
Cognitive Therapy, it has a unique philosophical basis that centers on self-
regulation. TM teaches people how to regulate their thoughts and feelings
to become more aware of how they think about certain situations.

How do these CBT interventions work?

CBT interventions work by helping people gain insight into the thoughts,
feelings, and behaviors that are causing them anxiety or stress.

Reality therapy can help people gain insight into how they react to social
situations by teaching them to become aware of their thought patterns and
how they make judgments about the future.

Dialectics works by helping people examine the thoughts that cause their
anxiety and stress rather than relying on listening to their irrational beliefs.

Acceptance and commitment therapy helps people learn how to regulate

their emotions by identifying situations in which they feel anxious. For
example, a person could be taught to focus on one thing at a time instead of
trying to accomplish multiple tasks simultaneously during stressful times.

Transcendental meditation helps people become aware of the negative

thoughts that cause them anxiety by helping them gain a sense of stillness
in their minds, allowing them to identify this negative thinking more easily.

Overcoming anxiety and stress is a challenge that requires the help of a

trained mental health professional. Some people with anxiety disorders may
be able to overcome them alone by using anxiety self-help strategies and
therapy, such as CBT. However, more people benefit from the help of a
therapist trained in CBT interventions and other anxiety-related treatments.
This can include Cognitive Behavioral Therapy (CBT) and other forms of
psychotherapy for anxiety disorders, such as psychodynamic therapy and
client-centered therapy.

These interventions have been proven effective in treating anxiety disorders

and can help people overcome their fears, worries, and feelings of panic.
Moreover, there are many other ways people can learn to manage their
anxiety and stress, including professional anxiety treatment, acupuncture
treatments, exercise, and medication.

Even though hundreds of different types of anxiety disorders can affect

people in specific ways, the good news is that many different types of
interventions are available to help overcome these fears. Learn more about
how you can get help for your anxiety or stress-related condition by
speaking with a mental health professional today.

CBT is a therapeutic approach that employs skills to manage to worry,

stress, and other symptoms associated with psychological disorders. CBT is
effective in the treatment of a variety of psychological conditions, including
panic disorder, generalized anxiety disorder (GAD), social anxiety disorder,
obsessive-compulsive disorder (OCD), post-traumatic stress disorder
(PTSD), depression, personality disorders, and eating disorders.

Some CBT interventions are generally preferred over others because they
have been proven more effective in treating certain disorders and episodes
of anxiety than other similar approaches. However, the overall effectiveness
of CBT, as well as whether a particular intervention is more or less effective
than others, depends on a variety of factors, including the severity and
duration of emotional disorder symptoms experienced by the patient, their
experiences, and personal history with emotional disorders, cognitive
abilities, personality traits and previous treatments they have received.

CBT interventions involve different strategies designed to assist people

experiencing mental health problems such as stress or anxiety by working
with them to overcome their feelings of distress or reduce their reliance on
irrational beliefs that may be causing symptoms.

CBT interventions also involve techniques designed to change people's

thoughts, feelings, and behavior. For instance, some interventions focus on
helping people understand how their feelings and thoughts are causing
symptoms such as anxiety, depression, or irritability. Other interventions
help people to identify and make positive changes in their thoughts, beliefs,
and behaviors that may prevent them from experiencing mental health
problems in the first place.

CBT does not only involve behavioral changes such as changing your diet. It
includes several other strategies to change your thoughts to feel less
anxious and stressed. CBT encourages people to think positively about
themselves rather than focusing on negative experiences in their life.
Changing how you think about yourself is changing how you feel, which can
help improve almost all symptoms of psychological disorders.

CBT interventions are not for everyone. They can be very challenging and
require dedication and commitment from the person receiving CBT
interventions to overcome their feelings of distress, anxiety, and irrational
beliefs. In addition, some people do not enjoy being made to change the way
they think and behave because they would instead continue in their old way
of thinking or behaving, which may have been causing them problems in the
past.

CBT is based on the idea that it is possible to change how we think about
ourselves and our environment by changing our behavior and helping us
take positive steps towards improving our life situations.

Trained psychologists can use CBT interventions with people experiencing

mental health problems, especially those experiencing anxiety and stress.
These psychologists can also employ behavioral therapy techniques that are
not part of traditional CBT interventions but are similar, such as cognitive
restructuring.

Cognitive restructuring involves a person changing their beliefs about

themselves or the world by challenging their irrational beliefs or
challenging their negative self-talk. For example, a person suffering from
depression may challenge the negative thinking they have associated with
feeling depressed to improve their mood.

Cognitive restructuring is often used with other CBT interventions to make

them more effective. This can include changes in a person's behavior
learned by practicing different skills during CBT sessions.

CBT interventions can be tailored to the needs of a particular person and

are designed to help you understand your feelings and thoughts and how
these are causing your psychological difficulties.

Some people may benefit from receiving CBT interventions over a more
extended period than others, depending on the severity and duration of
their symptoms and their ability to cope with their anxiety or stress. Other
people can benefit from receiving just one CBT intervention and then being
referred to a psychologist for further counseling to address their
psychological needs.

CBT is a very practical approach for treating many mental health problems
because it focuses on helping you understand your feelings and thoughts
and how these feelings and thoughts are causing your irrational beliefs. In
addition, by understanding how these feelings, thoughts, and beliefs are all
connected, you can begin to work on changing them so you feel less anxious
or stressed in the future.

Post-traumatic stress disorder (PTSD) is a type of anxiety disorder that can

develop following the experience or witnessing of a terrifying event. The
type of event that triggers PTSD can vary and may be directly experienced,
witnessed, or even learned about.

The symptoms of PTSD are wide-ranging and include emotional distress,

mood changes, increased or decreased arousal, and changes in sleeping
patterns or a combination of these symptoms. These symptoms can also
vary from person to person, depending on the trauma they have been
exposed to.

Those people experiencing PTSD feel emotionally distressed and re-

experience their traumatic event over time as if it were happening all over
again. Often people with PTSD experience "flashbacks" where they feel as if
they are experiencing their traumatic event all over again, as well as
nightmares where they dream about aspects of their traumatic event.

Essentially, PTSD is a psychological reaction to an experience that has been

difficult or even traumatic to cope with. This means it can develop as a
response to any event, such as witnessing, taking part in, or experiencing
physical violence, abuse, terrorist attacks, or natural disasters. Often
anxiety disorders develop after trauma individuals receive little support and
hope from others regarding their experiences, which can lead to PTSD.

PTSD is often associated with other mental health problems, such as

depression and anxiety. Cognitive Behavioral Therapy (CBT) is an effective
treatment for people with PTSD by helping them learn how to change their
thoughts about themselves and their traumatic experiences to find more
effective coping methods.

Cognitive Behavioral Therapy can help people with phobias because it helps
them to:

Learn how to understand better the thoughts and feelings that cause their
fears and phobias.

Identify maladaptive thought patterns which make the fear worse. For
example, a person afraid of dogs may believe that all dogs are dangerous,
even though they have not come into contact with any hurtful dogs in the
past.

Learn how to better deal with their fear by facing the object of their fear
and reducing their triggers, such as eating disorders.

So, cognitive behavioral therapy is a type of psychotherapy that can help

you understand where irrational beliefs or thought patterns are causing
your stress and anxiety to teach you new ways of coping with them.
To be most effective, CBT interventions need to be tailored to the
individual's experiences and personality. This means that these
interventions are likely to be conducted by a trained mental health
professional who will ask questions about your thoughts, feelings, and
behaviors to help you understand where your negative thinking patterns are
coming from.

What are CBT interventions used for?

CBT interventions are used for a wide range of psychological problems.
These include:

Cognitive behavioral therapy is used to help people understand the

relationship between their thoughts and feelings, how their thoughts and
feelings are related to their behaviors, and how they can change these
cognitions to feel more relaxed and cope better with their emotions.

Developing a greater understanding of your thoughts, emotions, and

behaviors is often the first step in positively changing them. The CBT
interventions will then help you learn new ways of coping with anxiety or
stress by focusing on specific skills that need improving or other areas
where changes may be beneficial.

Learning these new coping methods will help you become more confident in
managing your emotions rather than relying on other people for support.
CBT interventions encourage you to take control of your own emotions
rather than leaving them under the control of other people.

This approach may be particularly helpful for people experiencing stress,

anxiety, or depression if they wish to feel more in control over their
emotions and reactions. However, if you regularly feel anxious, stressed, or
depressed, it is best to discuss your concerns with a trained professional
who can carefully consider the specifics of your case and provide you with
the appropriate CBT interventions.

CBT can also be helpful for people experiencing depression, anxiety, or

stress if they are unable to cope with their emotions, either due to a lack of
understanding about their thoughts and feelings or because their thoughts
and emotions are causing them excessive levels of grief.
Many different types of CBT interventions are available depending on the
specific issues that need to be addressed. For example, there are various
interventions for anxiety disorders, such as panic disorder, generalized
anxiety disorder, specific phobias (such as fear of dogs), and social anxiety
disorder.

Therapy for generalized anxiety disorder (GAD), a chronic and excessive

worry about everyday problems and life in general, is intended to help you
understand how your thoughts cause you to feel anxious and act in ways
that worsen your problems. In addition, these interventions will help you
learn new coping methods so that you can better manage your emotions
without allowing your worrying to create more problems.

There are also different interventions for specific phobias, such as fear of
heights or public speaking. These interventions teach you how to change
your thought patterns so that you see the object of your phobia as a regular
everyday occurrence rather than something which causes excessive fear
and anxiety.

Psychotherapy interventions for social anxiety disorder are intended to help

you feel more comfortable in social situations. These interventions often
include exercises where you practice your skills in a safe environment, such
as with a trained therapist, so that you become more confident using them
alone.

Psychotherapy interventions can also be tailored to people experiencing

stress, anxiety, or depression and wishing to develop new ways of managing
their emotions and feelings. This can be particularly helpful for people
experiencing difficulty when it comes to expressing their emotions, such as
bottling them up rather than sharing them with trusted friends or family
members.

Psychotherapy interventions can help you learn ways of expressing your

emotions and thoughts to manage intense or overwhelming feelings better.

CBT interventions can help you deal with your problems, even if they aren't
related to feelings of anxiety or stress. Once you understand how your
negative thoughts and feelings are causing you trouble, CBT interventions
can help you develop better ways of coping with feeling more relaxed and
confident in managing your emotions and reactions.

CBT interventions can help you better understand your thoughts and
emotions and become more confident in managing them. This is often the
first step in learning how to cope with your problems and prevent them
from worsening, which can make you less stressed, anxious, or depressed in
the future.

Disadvantages of CBT interventions

Despite the many benefits CBT interventions can provide, they have some
limitations. These include:

a. CBT interventions are often only as effective as the skills you learn.
Without these skills, CBT interventions may not achieve their full potential

b. Some people may not benefit from CBT interventions in certain

circumstances or because they do not fit their situation or personality. For
example, some people may already have a strong support network in place,
so there is less need for them to develop their coping strategies. Others may
be too attached to traditional psychotherapy and resist learning new ways
of thinking about their problems. In these cases, it is best to consult with a
trained professional who can provide an alternative approach suited to your
needs

c. CBT interventions may not be effective for people with severe mental
health problems or substance use issues. For these cases, it may be best
first to consult a trained professional who can determine if inpatient
treatment is necessary or if there are other ways of helping you address
your issues

d. Some people may be uncomfortable with the idea of psychotherapy and

believe that their problems don't need "fixing" or would instead learn new
coping mechanisms on their terms. Since CBT is mainly about learning to
cope with your own emotions, it may not be a practical approach for these
people.

CBT interventions are a middle ground between traditional psychotherapy

and more practical approaches like cognitive behavioral therapy. In the
past, therapists were only trained to provide long-term psychotherapy
interventions that help patients explore their thought patterns and identify
areas where they may be causing problems. This was often beneficial for
those experiencing severe mental health issues which needed long-term
therapeutic support and guidance to learn the skills necessary to cope with
their problems. However, this approach may not be appropriate for people
who want to learn new coping strategies or manage their problems.

CBT interventions are also a valuable complement to psychotherapy

interventions, especially for people with milder anxiety disorders struggling
to manage their symptoms even with the traditional techniques that
therapists have been trained in. In addition, CBT interventions can help you
learn better ways of dealing with your emotions and thoughts in different
situations to develop more effective techniques when facing similar future
situations.

CBT interventions are also helpful in helping you manage your other
problems related to mood and mental health rather than just anxiety or
depression. Many different types of CBT interventions exist, each with its
benefits. This means a CBT intervention is available to help you deal with
any problem you are experiencing.

The most accurate way to determine the best type of CBT intervention is by
consulting a trained professional who can carefully consider your specific
situation and provide the appropriate interventions to help you feel better
and manage your emotions effectively in the future.
 Basic CBT framework
Cognitive behavior therapy is a form of psychotherapy that aims to change
thoughts and behaviors by addressing their underlying cognitive processes.
It has been applied to many disorders, but treating anxiety and depressive
disorders is the most well-known.

It is based on the theory that thoughts are triggered in response to

events/situations, including bodily sensations, memories, or questions.
These thoughts often (but not always) lead to feelings such as anxiety or
depression.

For instance, when one is alone in a room, one may think, "what if someone
comes in." This thought may make them feel anxious. They may think: "I
must be experiencing a heart attack" (because they feel so anxious). This
thought makes them feel more anxious.

However, if they think: "It's okay to be anxious sometimes." They may then
feel better. It is important to note that these thoughts are automatically
triggered by the situation and are not consciously chosen by the person.
However, people can learn that their thoughts follow a certain pattern and
eventually challenge their automatic negative thoughts with
alternative/positive thoughts.

In cognitive-behavior therapy (CBT), patients are taught to challenge their

automatic negative thoughts with alternative/positive thoughts, to address
their anxiety and depression. By changing how they think about themselves
and how they interpret their experiences, the patient can change their
emotional response. As the patients' anxiety begins to decrease, they can
also use this new barrier to manage physical symptoms of anxiety (such as
trembling or sweating).

Four principles underlie the cognitive-behavioral model. They include (1)

automatic thoughts, (2) dysfunctional attitudes, (3) core beliefs, and (4) self-
esteem.

The first principle is automatic thoughts. These thoughts occur in reaction

to an event/situation before we even have time to think about them. They
are sometimes called "hot" thoughts because they are elicited by something
in the environment. For example, one may feel a sensation and then
experience a negative thought (e.g., hot flashes). Automatic negative
thoughts tend to be highly exaggerated or unrealistic.

The second principle is dysfunctional attitudes. These negative beliefs result

from one's automatic thoughts and responses. Negative attitudes (e.g., "I
am worthless") can lead to self-destructive behavior, such as alcohol or drug
abuse or severe depression in the patient. Self-esteem is a term used to
describe a person's positive views about themselves, their abilities, and
their beliefs about the world.

The third principle is core beliefs. They are statements that persist over
time despite contrary evidence because they have been formed with strong
emotion by using logic when forming them initially (e.g., "I am helpless" and
"I will never be happy"). These core beliefs tend to be negative and can
make people feel fearful, anxious, and worried about certain situations.

The fourth principle is self-esteem. It is a person's overall evaluation of their

worth, including their actions and attitudes; it is often used synonymously
with the term "self-worth." Self-esteem affects how people interact with
others, cope with problems, and handle criticism. It can change in reaction
to positive or negative events in one's life (e.g., being praised or criticized).
Self-esteem is an important concept when dealing with depression because
research has shown that when self-esteem goes down, depression increases.

Cognitive-behavioral therapies can treat various disorders, including

somatic anxiety – anxiety rooted in the feeling of physical symptoms
triggered by an event/situation. For instance, a person may experience the
sensation of cold, then feel anxious about the sensation that occurs. Another
example would be getting stressed when seeing a spider in their room at
night. The patient must learn to recognize these somatic sensations and
challenge their automatic negative thoughts with alternative/positive
thoughts (e.g., "It's okay to get cold sometimes.").

Consequently, there are different phases of the CBT framework, such as:

Phase one: assessment

This phase includes a detailed clinical evaluation to determine the type of
disorder the patient suffers from. The evaluation includes questions about
the patient's symptoms, social and occupational functioning, history of
mental disorders, and personality. In addition, the patient's negative
automatic thoughts are identified, and the consequences of these thoughts
are assessed. The patient is also asked to complete a questionnaire
regarding their negative beliefs such as "I am helpless," "I will never be
happy," etc. Cognitive-behavioral therapy generally includes many sessions
with the patient and the therapist.

Assessment first looks at the patient's symptoms and underlying beliefs. The
therapist then asks the patient to complete self-report measures of their
negative thoughts, feelings, and behaviors (such as the Beck Depression
Inventory). These measures give the therapist important information
regarding how much thought problems contribute to a patient's referral
symptoms. Moreover, the patient learns what is causing the symptoms and
why. As the patient's negative automatic thoughts and feelings decrease,
they learn that they can cope with situations better.

Consequently, recovery in CBT involves the establishment of new beliefs,

behaviors, and value systems that are more congruent with who the person
wants to be. This will also lead to increased self-esteem and decreased
feelings of helplessness.

This phase is essential since it allows the patient to understand the triggers
and consequences of their maladaptive beliefs. It is also important because
it gives patients time to recognize their maladaptive thoughts and practice
coping with these situations. In addition, these beliefs are now so patients
can apply them in the future.

Moreover, assessment is important since it gives the patient a chance to

think about how they see themselves and how others view them. This helps
the patient change negative perceptions about themselves, develop more
effective coping strategies for dealing with their emotions, and learn to
accept that other people have different opinions than theirs. The
assessment also includes a medical history and clinical interview for
physical causes of symptoms. Therefore, there is a need for accurate,
thorough, and consistent assessment before proceeding to the next phase.
 Phase two: re-conceptualization
The second phase involves the re-conceptualization processes. This is the
stage where patients learn about their negative thoughts and how distorted
they are. Patients also develop alternative, positive thoughts and other ways
to cope with their stressors/situations to help decrease negative symptoms.
Re-conceptualization includes:

a. Identifying the negative thoughts:

This phase is important because it allows patients to identify their

automatic thoughts and underlying meanings.

b. Identifying the negative emotions:

This process is important because it allows patients to recognize how these

distorted thoughts can lead to maladaptive behaviors, such as depression. It
also allows the patient to develop coping strategies for dealing with their
stressors/situations. For example, if a patient feels hopeless and helpless in
a situation, they can talk with someone about it or try to find another
solution for this problem. In addition, self-monitoring is another tool
patients can use to recognize their automatic thoughts and develop a plan
of action based on those thoughts.

c. Identifying the consequences of negative thoughts:

This is important for patients to see how their distorted beliefs can
contribute to their symptoms and feelings of hopelessness, helplessness,
and worthlessness. Patients learn to be successful by accepting that they
can change negative thought patterns and learn to use alternative positive
behaviors. They also begin to see that other people have different opinions,
which will help them accept other people's opinions without feeling
threatened or rejected.

d. Identifying alternative, positive thoughts:

This is important because it allows patients to develop alternative ways of

thinking about themselves and more healthy and realistic situations. As a
result, patients come up with alternative beliefs regarding themselves and
their patients, which leads to a self-esteem increase that helps them deal
with situations more healthily. Furthermore, patients learn more effective
ways of coping with their negative feelings and stressors.

e. Developing alternative behaviors and coping strategies:

CBT can be beneficial because it helps patients develop alternative and

positive behaviors that are more congruent with their characteristics,
values, and needs for attention. In addition, the patient learns how to better
manage their emotions by developing new coping methods (such as actively
seeking out sick leave or talking to someone). The goal is for the patient to
learn that they can change or cope with situations without needing
medication. This phase is important for identifying the patient's negative
thoughts, beliefs, and consequences of their maladaptive thinking. It is also
important because it allows patients to view other options as ways to cope
with situations. In addition, this phase allows the patient to learn that they
can change and cope with situations independently without medication. This
helps them develop self-esteem so they can deal with situations more
positively.

Re-conceptualization involves the identification of maladaptive thoughts,

emotions, and consequences. For example, if the patient believes they are
not good enough or unlovable, they may feel and act differently in the
future. These maladaptive beliefs can contribute to symptoms such as
depression and suicide attempts. In addition, this phase involves identifying
alternative ideas that are more congruent with the patient's positive
characteristics. These positive ideas help diminish maladaptive thoughts
and increase self-esteem. By recognizing the negative effects of these
distorted beliefs, patients better understand their emotions and behaviors
to change their ways of coping with stressors/situations. In addition,
patients learn more effective ways to cope with their emotions and
dissociation thoughts.

In general, re-conceptualization is when patients learn to change the

meaning of their thoughts by recognizing the negative consequences of
their distorted beliefs. It involves identifying the beliefs and negative
emotions that lead to maladaptive behaviors such as depression and mood
swings. The goal is to develop new ideas congruent with their positive
characteristics. In addition, this phase involves identifying alternative ways
a patient can cope with stressors/situations on their own without overusing
medication. It also involves learning more effective coping strategies for
dealing with stressors/situations. Finally, this phase involves the patient
accepting the idea that they can successfully change their behaviors,
thoughts, and emotions by not over-relying on medication. It is important to
identify when patients over-rely on medication because this can lead to
negative consequences by inhibiting their natural ability to cope with
stressful situations.

Re-conceptualization helps patients develop positive traits to become more

optimistic, stable, and coherent. Generally, re-conceptualization is
important for developing positive characteristics that will help increase
coping skills, reduce maladaptive thoughts/behaviors and alleviate
symptoms of mental illness. In addition, it is important because it helps
patients realize how they can successfully change their maladaptive
thinking and behaviors. Finally, this phase involves re-conceptualizing
thoughts, behaviors, and emotions to deal with situations more healthily
without medication, which helps patients develop self-esteem.

Therefore, this phase is important because it allows patients to learn

alternative beliefs, behaviors, and coping skills to help them overcome and
manage their symptoms. It also increases self-esteem, which helps the
patient cope with negative feelings and stressors/situations healthier. This
phase is important for eliminating distorted thoughts, accepting other
people's opinions, and learning how to cope with emotions healthily.

Although this phase is important because it helps patients realize

alternative ways of thinking and behaving, one may argue that it is also
unrealistic. Many people believe that medication should always be given to
patients, no matter how much they believe it does not provide any real help.
This may be true because a patient may become dependent on the use of
stimulant medication and other psychiatric drugs to provide relief from
symptoms and behaviors. In addition to this, many people believe that the
patients will not benefit from CBT because it can lead to anxiety and stress
for the patient. Therefore, psychotherapists, psychiatrists, family members,
and friends must educate themselves about alternative treatments for
patients with mental illness before choosing between two treatment options.
Moreover, patients must be educated about the benefits of both treatments
to make informed decisions when choosing treatment options. The process
of CBT can be time-consuming, but many believe it is beneficial to learn
new ways of thinking and to behave to become more stable, coherent, and
healthy.

Phase three: skills acquisition

This phase generally involves the patient learning alternative ways to cope
with stressful situations. This can be accomplished by learning new ways of
thinking concerning the patient's symptoms (to learn healthier alternative
definitions and behaviors). This allows for more mature and effective ways
of coping with stressful situations. However, this may be difficult if a person
feels that their maladaptive thoughts are realistic or accurate. This can be
accomplished by identifying alternative ways they can cope with stressful
situations, including practicing healthy behaviors such as seeking treatment
at their local mental health clinic. In addition, this phase involves the
patient learning new skills to help them maintain a stable lifestyle by
reducing maladaptive behaviors such as excessive drinking or medication
intake. For example, a patient may learn to find new ways of coping with
stressful situations and emotions that decrease the risk of relapse of
symptoms. An example of this would be if a patient drinks too much alcohol;
they could understand that they have developed a negative thought such as
"I drink too much, I'm worthless as a person, I am an alcoholic" or another
maladaptive thought and ask someone for help (ex: their therapist or
psychiatrist).

In addition, patients can work on developing alternative ways to cope with

the symptom by learning new skills to decrease maladaptive thoughts,
emotions, and behaviors, such as recognizing that these thoughts are not
factual and in tune with reality. Moreover, patients can work on developing
coping skills by learning new alternative ways that they can think and
behave to reduce stress and negative emotions. However, this may be
difficult because some patients have redefined their maladaptive thoughts
as realistic, believing that their negative thoughts are accurate. In addition,
some patients may have unrealistic thought patterns that cannot be
changed. For example, some people may believe they are superior or
inferior to others based on their race or social class, which cannot be
changed. In general, this phase involves the patient accepting new ways of
thinking and behaving to help them become more stable and reduce
symptoms of mental illness to lead a more coherent lifestyle.

In addition, this phase is important because it teaches the patient to cope

with stressors and symptoms of mental illness by learning new skills. It is
important to note that patients are not taught how to cope with stressors
while in the hospital or taking medication. Therefore, this phase helps
develop coping skills to help prevent relapse and undesirable consequences
of mental illness. Although the process is time-consuming, many patients
believe it is beneficial because it helps them develop useful skills that will
help them manage their symptoms more effectively without medication.
Moreover, some may argue that teaching patients how to cope with mental
illness is unnecessary because patients can learn how to cope with stressors
independently, and psychiatric drugs will help them cope with the stressors
and symptoms of mental illness.

In addition, this phase may be important in helping the patient develop a

relationship with the therapist or psychiatrist they seek treatment from.
This is because they are working together to overcome the symptoms of
their mental illness. This phase may also be beneficial because it allows
patients to express themselves more effectively and helps them deal with
their emotions healthily. These new coping skills can help organize
behaviors and thoughts that will allow patients to lead healthier lifestyles,
leading them toward recovery. To help the patient reach this stage, the
therapist or psychiatrist must know about alternative mental illness
treatments.

However, this phase is difficult because there may be a lack of

communication between patients and their therapist or psychiatrist due to
different cultures and values. This can be overcome if the therapist is well-
versed in alternative treatments for mental illness, such as CBT, and
understands that alternative treatment does not necessarily mean that a
patient will become dependent on medication. Some argue that care should
always be provided to patients with mental illness regardless of their
treatment (such as medication). Others argue that care should not always
be provided because it contributes to dependency, stigma, and lack of
recovery.

This phase involves the patient learning alternative ways to cope with
stressful situations and symptoms of mental illness through different
methods such as cognitive restructuring and new behaviors. The patient can
communicate more effectively with their therapist or psychiatrist through
these new techniques. Moreover, these skills help patients reorganize their
thoughts and behaviors, which helps them recover from symptoms of
mental illness. However, this phase may be difficult for some patients
because some cultural values and beliefs may not be compatible. This can
be overcome by being well-versed in alternative treatment methods (such as
CBT) and how they can benefit the patient's recovery process.

In addition, this phase requires a patient to believe that mental illness is

biological and treatable. However, some argue that this belief may be
inaccurate because mental illness may not be biological. However, these
patients understand that symptoms of mental illness are caused by their
thoughts and behaviors, and they do not have any other explanation for why
they have symptoms of mental illness. Moreover, these patients understand
that if they continue to drink alcohol, they will develop another mental
illness, such as alcoholism. However, this phase is difficult for these
patients because they often believe that their symptoms are always caused
by their lifestyle and their current environment. This can be overcome by
educating patients on the importance of healthy lifestyle choices and
encouraging them to increase control over their thoughts and behaviors.

This involves prescribing medication to help control symptoms of mental

illness. In general, people tend to receive psychotropic medication for their
symptoms of mental illness to be controlled. In addition, patients need to
receive psychotropic medications to treat future relapse or undesirable side
effects to get better results from treatment and reach a positive outcome.

Phase four: skills consolidation and application

This phase involves the patient becoming more independent because they
have learned effective coping skills to manage their symptoms of mental
illness without medication. Medicine can still be prescribed to help reduce
symptoms; however, patients often believe medication is unnecessary
because they have learned healthy methods to cope effectively.

This phase is difficult for some patients because if they are not complying
with the prescription, it may be viewed as a failure on their part as a
patient. However, this phase benefits patients because it helps them
become more independent and healthier. For example, the patient may
learn how to avoid or reduce stressors or situations that trigger anxiety and
other symptoms of mental illness. Patients may also learn new behaviors
(e.g., physical activity) that can help reduce symptoms of mental illness.

Furthermore, this phase is important because it helps the patient realize

that their symptoms of mental illness are real and that they need to take
control of them. Patients usually believe it is best to avoid symptoms rather
than manage them. For example, patients may use alcohol to suppress
stress instead of communicating with others if they find the situation
stressful or confront the person causing the stressful situation. Moreover,
these coping skills can help organize behaviors and thoughts, allowing
patients to lead healthier lifestyles and prevent relapse more effectively
than medication.

Therefore, this phase is beneficial for patients because it helps them

develop the necessary skills to prevent relapse and the undesirable
consequences of relapse more effectively than medication does.

Skills consolidation is important because this stage is where patients

develop the necessary skills to prevent relapse and undesirable
consequences related to relapse more effectively. For example, the patient
learns new ways of coping with symptoms, such as using relaxation
exercises instead of drinking alcohol. In addition, the patient learns to use
stress management techniques, such as meditation, breathing exercises,
and physical activity. These skills help the patient relieve symptoms
triggered by stressful situations and reduce the overall negative impact of
stressors on the body. As a result, patients feel more in control of their
mental illness because they have learned to manage symptoms without
medication rather than just suppressing them.
In addition, this phase requires patients to comply with their treatment plan
and continue taking medication for a specified period. Many believe
patients should take their medication as prescribed instead of "gambling"
with their mental health. The patient needs to have a strong desire to get
better because they must follow the prescribed exercise plan, which may
include taking medication for some time. Nonetheless, this phase requires
the patient to comply with medication to get better results from treatment
and reach a positive outcome instead of focusing on symptoms of mental
illness or relapse. Furthermore, medications should be taken as prescribed
because they play an integral role in successful recovery by controlling
symptoms and preventing relapse.

This phase is difficult for patients because it requires them to understand

that the medication works slowly. However, this phase can be overcome by
educating patients on the benefits of medication, how their body processes
medications, and why it takes time to see results from treatment.

This is important because patients need to learn what causes relapse and
how to prevent it. Patients who use alcohol or drugs in this stage are more
likely to relapse than those who do not.

Therefore, this phase helps prevent relapse because people are on

medications for a specified period instead of "gambling" with their mental
health and experiencing undesirable relapse-related consequences.
Furthermore, it improves compliance with treatment and increases the
quality of life while managing symptoms of mental illness.

A medical home expands the medical system where all aspects of care are
considered to ensure that the patient receives quality, safe and coordinated
care. Inclusion of mental health professionals in the medical home is
possible as long as they work within a multidisciplinary team with
physicians, nurses, and other health professionals who provide highly
effective care.

The usual starting point for a person with a medical illness is the office visit,
where the patient meets with a physician who examines them and
determines if their condition needs to be addressed. If not, the patient
might be referred back to their primary care physician or direct primary
care physician, depending upon which doctor visits first.

Skills application is important because it allows patients to apply skills

learned in earlier phases to do better without symptoms of mental illness.
Furthermore, this phase helps people learn how to manage symptoms
without medication or with less medication.

This phase is difficult for patients because they may not remember how to
use their coping skills when applying them to daily activities or situations.
However, this can be overcome by using relaxation techniques and
practicing new coping skills in stressful situations. Furthermore, a patient
can use the support of their family and friends to help them apply their
learned coping skills to stressful situations in their daily life, thereby
preventing relapse more effectively than medication does.

This phase is important because it helps patients maintain progress through

continued self-care, monitoring, and skills. This ensures that the patient will
not relapse for a long period. In addition, this phase gives patients the
chance to learn to manage symptoms of mental illness more effectively than
medication does.

This is a difficult phase for patients because they must stick with their
treatment plan and avoid situations and circumstances that could cause
relapse or the undesirable consequences related to relapse.

Therefore, that phase is important because it helps improve compliance

with treatment by enhancing motivation and dedication to get better
without symptoms of mental illness or with fewer symptoms or medication
than before treatment started.

This is the most important phase because it helps patients avoid relapse and
the undesirable consequences related to relapse and improves compliance
with treatment. In addition, this phase enables patients to stick with their
treatment plan, including abstaining from alcohol or drugs.

This is important because it helps maintain the gains achieved in earlier

phases and leaves patients more in control of their mental illness.
Therefore, it helps people learn how to manage symptoms without
medication or with less medication.

In addition, drug holidays can be taken to help control symptoms of mental

illness and prevent relapse. Furthermore, this final phase allows people to
learn how to feel better by managing symptoms with fewer medications
than before treatment began.

Phase five: generalization and maintenance

Treatment is not complete until the skills a patient has learned and
practiced in earlier phases are applied to future situations. Therefore, when
a patient leaves an inpatient or outpatient facility, their treatment provider
needs to assist them with generalization to ensure that they do better at
home rather than worse.

This phase is more important because it enables patients to apply their

coping skills and learn how to cope with symptoms without medication or
with less medication. Therefore, it helps people do better without symptoms
of mental illness or with fewer symptoms or medication than before
treatment started.

This phase may be difficult for people who are not as motivated to do better,
but it is necessary for their mental illness. Furthermore, it helps people
learn how to feel better by managing symptoms with fewer medications
than before treatment started.

This is a difficult phase for patients because they need to learn how to deal
with their lives at home and the stressors associated with everyday life. In
addition, patients with difficulty adjusting or accepting life changes usually
find it difficult to cope with their mental illness and relapse.

Therefore, this phase encourages patients to adjust or accept change while

focusing on maintaining progress without symptoms of mental illness. This
helps them do well without symptoms of mental illness or with fewer
symptoms or medication than before treatment started.

This is important because it helps prevent relapse or the undesirable

consequences related to relapse. Furthermore, this phase allows patients to
maintain progress through continued self-care and monitoring symptoms.
This is a difficult phase for patients who do not want to comply with
treatment and maintenance. If a patient refuses treatment, they must
receive a strong message from their doctor that they need to comply with
their treatment plan if they are going to feel better and prevent relapse.

This is an important phase because it helps maintain the gains achieved in

earlier phases and leaves patients more in control of their mental illness.
Therefore, it helps people learn how to manage symptoms without
medication or with less medication.

This is a difficult phase for patients who have difficulty adjusting to or

accepting life changes. Unfortunately, patients with difficulty adjusting or
accepting change usually find it difficult to cope with their mental illness
and are likely to relapse.

Generalization and maintenance are important because they help patients

maintain progress through continued self-care, monitoring, and skills. This
ensures that the patient will not relapse for a long period. In addition, this
phase helps people feel better by managing symptoms with fewer
medications than before treatment started. This is important because it
helps people learn how to manage symptoms without medication or with
less medication. Therefore, this phase helps people do well without
symptoms of mental illness or with fewer symptoms or medication than
before treatment started.

In addition to helping patients learn how to apply their coping skills and feel
better by managing symptoms with fewer medications than before
treatment started, this phase allows people to use the support of family and
friends to help them cope more effectively with stressful situations in their
daily life.

Generalization involves the patient learning to apply their coping skills and
feeling better without medication or with fewer side effects than before
treatment. This is important because it helps people learn how to feel better
by managing symptoms without medication. This helps people do well
without symptoms of mental illness or with fewer symptoms or medication
than before treatment started. In addition, generalization helps patients use
the support of family and friends to help them cope more effectively with
stressful situations in their daily life. Moreover, it helps people do well
without symptoms of mental illness or with fewer symptoms or medication
than before treatment started.

Maintenance involves the patient learning how to feel better by managing

symptoms without medication or with less medication than before treatment
started. This helps people do well without symptoms of mental illness or
with fewer symptoms or medication than before treatment started. This is
important because it helps people do well without symptoms of mental
illness or with fewer symptoms or medication than before treatment started.

The benefits of this phase degrade as the disease progresses and the
patient's abilities decrease. The patient may not be motivated to continue
the maintenance phase, but the benefits remain. In addition, these benefits
need to be monitored during routine visits in an outpatient department (at
home) because they can change at any time and may get worse.

This phase is more important because it allows people to do better without

symptoms of mental illness or with fewer symptoms or medication than
before treatment started. It helps patients use family and friends' support at
home. In addition, it helps people cope more effectively with stressful
situations in their daily life at home. In addition, a person may want to go
back and do more after feeling better. However, continuing the
maintenance phase is a good idea because it helps patients use their skills
and feel better without and with less medication than before treatment
started.

Psychotherapy is any therapeutic interaction between a trained professional

(e.g., psychologist, psychiatrist) and a client or patient, focusing on issues
concerning mental health. In particular, psychotherapy refers to "a goal-
oriented, intentional relationship between a mental health professional and
someone experiencing significant intrapsychic and emotional problems."

"Emotions can be maintained if they are repeatedly evoked by events that

trigger them, and the emotions that are triggered are usually those which
have been most recently experienced. Therefore, one must change one's
experiences to change one's emotional reactions."
This is important because it helps people learn how to feel better by
managing their symptoms without medication or with less medication. For
example, a depressed patient who feels something bad will happen when
they get angry and avoids feeling angry is likely to continue feeling
depressed for a long time.

Phase six: post-treatment assessment

The last phase is the post-treatment assessment. In terms of research and
practice, in this mental health process area, "post" means after the
treatment has gone on for a while: "the period following a course of clinical
intervention (e.g., psychotherapy) or a course of social support or
psychosocial interventions over time."

In this process area, the post-treatment assessment is any event or activity

that concerns how people are doing after psychotherapy for patients with
mental disorders or depression. The post-treatment assessment is also
known as "termination," which means "to stop or end something" or "the act
of making an end to."

In this phase, any changes are monitored to ensure that the patient is
making progress. If necessary, the treatment should be changed or adjusted
to fit the patient.

Components of post-treatment assessment may include:

a. The patient's mental illness diagnosis, symptoms, and severity.

b. The patient's response to treatment and psychotherapy and mood

before the onset of relapse.

c. The patient's readiness to begin psychotherapy or treatment with

medications to effectively manage their mental illness to help prevent
relapse or recurrence.

d. The patient's support systems and ability to cope with stressors

outside therapy for relapse and recurrence prevention.

e. The patient's adherence, or compliance, with therapy and treatment

to prevent relapse or recurrence.
f. The patient's level of functioning is measured by their ability to
maintain employment, complete education, manage their relationships and
social interactions effectively, etc.

g. The patient's response to the psychotherapy and treatment that they

received to prevent relapse or recurrence of their mental illness with less
staff involvement in therapy and more independence for the patient in daily
life activities such as employment training, school attendance, peer
relationships, and interactions with others (e.g., family members), managing
finances on an ongoing basis.

h. The patient's response to the psychosocial interventions and support

systems they received to prevent relapse or recurrence of their mental
illness.

i. The patient's ability to effectively manage their emotions as revealed

by their responses in psychotherapy, social support, and family
relationships.

j. The patient's insight about the causes and persistence of emotional

problems for relapse prevention; this usually requires psycho-education
about the causes of mental illness and strategies for managing emotional
problems in daily life.

Post-treatment assessment involves checking the progress of the therapy

and psychosocial interventions. The patient's progress can be checked by
monitoring symptoms, medication levels, and psychotherapy skills. The
results of the treatment and psychotherapy are also checked. If the patient
does not agree with the change in treatment and progress, they should be
invited to discuss it with their health care provider. Post-treatment
assessment helps determine whether the patient has responded well to
therapy and psychotherapy and whether the treatment is working.

The results of post-treatment assessment influence how therapy should

continue. If therapy is effective, it should be continued until the patient can
adjust without medication or with lower medication dosage. The clinician
must decide whether a person who can survive without mental illness
medications needs regular therapy or more social support, such as family
and peer support.
In the end, post-treatment assessment helps people learn how to live better
with their mental or emotional problems. Moreover, the treatment and
psychotherapy results are used to make more informed decisions regarding
future treatment.

Therefore, the post-treatment assessment phase of mental health is an

ongoing process that varies from one individual to another, depending on
their needs and circumstances. In addition, the post-treatment assessment
phase is a process that must be repeated repeatedly to keep the person with
mental or emotional problems from relapsing.

A common question about post-treatment assessment is whether patients

should continue taking psychotropic medications or if they can stop taking
them on their own. The answer depends on a few factors:

a. Patients with severe mental disorders, such as schizophrenia and

bipolar disorder, are more likely than others to need to stay on psychotropic
medications for life.

b. Patients who take medication inconsistently or forget to take them

should be reminded of their need to do so and helped in every way they can
to remember and adhere to the treatment plan.

c. Psychotherapy goes hand in hand with the use of medication because

psychotherapy addresses emotional issues and social supports (e.g., family
or peer support) that affect how patients cope emotionally, socially, and
behaviorally. Psychotherapy helps patients to develop new thoughts and
patterns of behavior that have a positive effect on their mental and
emotional status.

d. Patients with a mental disorder (e.g., depression) that has been

successfully treated with psychotherapy may not need psychotropic
medications. But these patients are still at risk for relapse unless they
continue to practice the skills learned in therapy and develop strong social
support for themselves.

The results of the post-treatment assessment phase will depend on the

clinician's conclusions about a person's symptoms, severity, and level of
functioning before beginning therapy or treatment with medication.
Mental illness is a serious issue affecting millions worldwide. It is important
to understand that there are different types of mental illness, and treatment
varies depending on the form. Treatment depends on the type of symptoms
the patient is experiencing; therefore, different treatment methods may
work better for some patients than others. Treatment options include
psychotherapy, medication (such as benzodiazepines), electroconvulsive
therapy (ECT), group therapy, and other alternatives such as diet and
exercise. According to Kahn et al. (2010), patients should choose from these
options based on their preferences and be open to discussing all aspects of
their lives with healthcare providers at any time during treatment.

Over the last few years, researchers have used neuroimaging to find out
how CBT works for people with mental illnesses. There has been a focus on
the hippocampus (which is important for long-term memories). This area
becomes activated during CBT as well as when people are retrieving
memories from long-term memory. It has been found that hippocampal
volume decreases when people have depression compared to healthy
controls.

Cognitive therapy has been used for several problems that are affected by
emotion. For example, depression has responded well to cognitive behavior
therapy (CBT) for patients with agoraphobia in tests on children and adults.
In addition, the International Journal of Eating Disorders has published
research showing that cognitive therapy can effectively treat bulimia.

Although cognitive behavior therapy is effective against depression and

bulimia, it has not been as successful for patients suffering from eating
disorders. However, treatment usually focuses on disordered eating
behavior, which may lead to decreased symptoms of other emotional
problems such as depression.

Therefore, the CBT framework should be expanded to include positive

emotions, coping and emotion regulation problems, and social relations.
This would make it more effective in dealing with eating disorders such as
bulimia nervosa.

In the past decade, cognitive exposure therapy has been used to help
depressed adults and children. Cognitive exposure therapy is a therapeutic
method where people are exposed via imagination to situations related to
the onset of their disorder or mood disturbance. For example, people who
fear flying will be exposed repeatedly to images of flying on the Internet or
in films until they no longer fear flying. In addition, people with agoraphobia
will have many opportunities via graded exposure exercises to be out in
public and learn ways to deal with their anxiety.
 How to identify emotional triggers
Cognitive behavioral therapy is about retraining the way your brain
responds to events, ideas, and “triggers.” For example, if you have been
struggling with anxiety, you might want to recognize the times when your
anxiety spikes in intensity. When do you feel it? What are you doing? Who
are you with? What specific thought pops into your mind at that moment?

Beyond these anxiety triggers, it can be helpful to start identifying

“idiosyncratic” triggers—those things or activities that work as a cue for a
strong emotional response. For instance, you may be anxious in certain
social settings but not others. You may face similar situations repeatedly,
and each time react differently. If so, you could try to identify a particular
pattern: “When I attend a play at an arts festival, I normally experience
some anxiety. Today, though? It was fine.”

Each trigger can be considered a weakness to the patient's ability to

maintain control of their emotions. The goal is for the patient to change
these weaknesses so that specific external cues no longer trigger the
feelings. This process is known as "autonomic regulation.”

Autonomic regulation can be accomplished by identifying the cue (the

“trigger”), determining the emotion that is associated with it (i.e., anxiety),
thinking of negative emotion, then practicing this new response to the
trigger until it becomes habitual. Examples of emotions opposed to anxiety
are calmness, relaxation, and happiness. For example, Agitated patient –
Calm response: "I am feeling anxious, but I'm going to choose a calm
response. Maybe I'll go sit down, relax my shoulders and breathe deeply.”

Determining the key emotion involves paying attention to the patient's face
and tone of voice. If the patient appears anxious or upset, the therapist
might ask questions or do other things to draw out the emotions: “What
happened that made you get anxious? What is it like when you get anxious?”
The therapist might determine what type of anxiety is experienced: Is it
fear? Is it worry? “When you are worried about something, your body
tightens up, and your muscles tense up. When you feel fear, your body
prepares to run or fight.”
The therapist will then help the patient identify an emotion opposite the
trigger. This may be a distraction tactic. For example, A person who is
anxious while driving might choose calmness as the negative emotion. The
person might say, “I'm going to count backward from 100,” or “I'm going to
try and relax my shoulders and take deep breaths.”

Once the patient has identified a calm response to the trigger, they can
learn to employ it using practice strategies. For example, the therapist
might ask the patient to think of a stressful situation likely to provoke the
trigger. The patient imagines themselves in this situation but instead thinks
of the soothing response. The therapist then asks the patient to rate their
anxiety on a scale of 0-10 (0 being no anxiety and 10 being extreme terror).
New triggers can be chosen if it's too difficult to imagine something
stressful.

Empirical studies suggest that people with post-traumatic stress disorder

(PTSD) do not get relief from their symptoms by imagining pleasant
memories as much as other patients do.

Instead, they often get relief by imagining the trauma that caused their
symptoms. In this case, it is suggested that the trauma is too prominent in
their minds and needs to be reduced.

To do this, the patient should imagine triggers and practice the positive cue
until it becomes a habit. Rewarding yourself for doing so can be helpful, as
it can be difficult to change habitual behavior. For example, it may help to
think of a reward associated with a positive response: “If I feel angry when
my boss yells at me, I'll take a few deep breaths and remind myself how
much I like my job.

Why emotional triggers occur

Many researchers believe that people suffer from anxiety because they
don't master (or forget) how to regulate the automatic responses of their
bodies and mind.

It can be helpful to think of your body as a car. Your brain is like the car's
computer: It processes information about your environment and makes
decisions, including when to remove your foot from the gas pedal and step
on the brake. The brain decides when you have had enough food, when you
are too hot or cold, and when to relax or contract your muscles. It regulates
your breathing, your heart rate, and hormone production.

The computer (your brain) must work properly. But if you are stuck in "high
gear" without the ability to switch to "low" or "park," stress can build up.
Therapy aims to understand what causes your anxiety and ways to change
reactions so you can respond more appropriately.

Emotional triggers occur when we react too strongly to a situation that we

perceive as threatening. We are experiencing such a threat because of our
experience with similar situations. Our brain has stored information about
this situation, which was experienced in the past, and makes us feel so
strongly about it that we feel terrible. For instance, an abusive father might
leave his child at the store, causing her to feel terror. The child's fear is
then stored in the brain, and she may react similarly if she sees or hears
something related to the actual situation, which triggers memories of the
abuse.

People experience many negative emotions, such as anger, sadness, and

anxiety. Emotions are processed automatically, outside of our conscious
control. Think of an automatic reaction to an emotional trigger like a voice
recording. When you hear your voice recorder go off in the morning, you
might say, "Oh no!" You may do this without thinking about it or even being
aware of what you are doing—your body reacts automatically.

Many people who have experienced trauma find themselves reacting to

certain situations similarly over and over again. For example, if you were
stuck in a car accident when you were 16, you might find that certain
sounds or feelings cause you to flash back and feel the same way as you did
when it happened. If that happens, try to bring yourself back to the present
moment, reminding yourself where and when. This can be difficult, but you
must learn to keep yourself here.

Many people who have experienced traumatic experiences are confused

about their reactions and behaviors. For example, they may be afraid of a
certain situation yet feel an urge to run toward it or act scared even when
there is no danger. The confusion makes it hard for them to see what they
are feeling or what they need to do next.

Often, we automatically go to extremes when we are feeling angry, fearful,

or upset. In a car accident example, if you are scared and the door is
opened suddenly by someone standing behind you, your automatic response
might be to jump and scream. However, if you have experienced a traumatic
event, this reaction may not be appropriate for current situations. Many
people with anxiety problems find they have a hard time knowing what their
reactions mean. For example, if someone tells you it is cold outside, you see
them wearing a coat and know it is not cold outside for them. But because
of your past experiences, you feel upset and cold (your brain is telling you
something is wrong). Many people with anxiety problems think, "this person
must be a threat to me," when the truth is that it is the cold weather itself.
This is another way your brain and body react automatically without
knowing the context of the situation.

Many people who have experienced trauma find it hard to control their
reactions to emotional triggers. As a result, people often respond when they
are triggered, even if they know that the response is not appropriate or
helpful in any way. This can cause frustration and confusion because you do
not understand why you reacted so strongly or felt so much anxiety.

It is important to learn how to control how you react and feel to reduce your
anxiety with help from a professional therapist or instructor. Once you
understand what triggers your anxiety, you will be able to respond
differently each time it happens. This will help you gain control of your body
and mind.

Therefore, emotional triggers occur when we react too strongly to a

situation that we perceive as threatening. Moreover, people often respond
when they are triggered, even if they know that the response is not
appropriate or helpful in any way. This can cause frustration and confusion
because you do not understand why you reacted so strongly or felt so much
anxiety.

There are other reasons as well, as I have described above, which you can
see in the above passage. It is important to learn how to control how you
react and feel to reduce your anxiety with help from a professional therapist
or instructor. Once you understand what triggers your anxiety, you will be
able to respond differently each time it happens. This will help you gain
control of your body and mind.

Therefore, you can reduce your anxiety. The above passage tells you where
the cause of anxiety comes from and gives some practical ways by which
you can deal with it. However, anxiety can also be reduced in other ways.
So it does not depend upon any one way, but many ways too – that is, by
reducing your anxiety with many different methods- by medicines and so on.

The causes of anxiety are different. What causes anxiety for one person may
not cause it for another person. The causes of anxiety in different cases
differ from those of the same case according to differences and similarities
among the cases experienced by persons suffering from illness or being
healthy.

Stressful events: Traumatic experiences can cause emotional triggers to

develop and become conditions that are difficult to overcome. Usually, the
reaction is more severe and intense than the first reaction.

Psychological/emotional/mental triggers: The stress and anxiety caused by

these events can cause emotional triggers to form, causing a condition that
is difficult to overcome.

Psychological/emotional/mental health issues: People suffering from

psychological or mental issues often develop emotional triggers. Combining
both situations can be very hard to deal with, whether the trauma occurred
before or after these issues.

Psychological/emotional/mental problems usually appear in one's teenage

years, while a trauma can happen at any time of life. Emotional triggers can
cause one to experience anxiety and depression, which can be hard to
control.

Psychological/emotional/mental issues are likely to cause an individual to

become very self-critical. Trauma usually causes one to blame him or
herself, which contributes to low self-esteem and can be hard to overcome.
Psychological/emotional/mental problems tend to make one feel isolated
from others, and this feeling of loneliness is a trigger for trauma survivors.
Therefore, it is important for individuals struggling with psychological or
mental issues and trauma survivors alike to seek guidance from a trained
professional to overcome emotional triggers.

Traumatic experiences usually result in emotional triggers that are not as

severe but can still create anxiety. These episodes of mild anxiety often
occur when the person is triggered by a specific event or situation instead
of responding to a random occurrence. Learning to detect these mild cases
helps you manage your anxiety better.

Repetitive thoughts: Repeated thoughts may occur because the trauma was
intense and allowed the memory to be stored in the brain more easily.
Though once learned, the thought will continue to resurface unexpectedly
unless it is dealt with on a conscious level.

Most people with anxiety are affected by their past experiences and their
anxiety. Adapting to these triggers and mastering the situations or
situations that cause them to happen can be difficult, even if you have
control over your current situation. Therefore, knowing what causes anxiety
is important to deal with it effectively.

Breathing exercises are an excellent way to deal with anxiety because they
help you center yourself, reduce muscular tension, and relieve stress.
Breathing exercises are a great way to reduce anxiety because they can
help you center yourself, reduce muscular tension, and relieve stress.
Moreover, they help you to be more in control of your reactions to stressful
situations.

Psychological treatment is also an effective way to deal with anxiety, as it

helps you learn how to react and respond appropriately in different
situations. For example, the therapist might ask about your past
experiences, which may release some buried feelings that can cause
anxiety.

Psychotherapy can also be very helpful in dealing with anxiety and

emotional triggers because it allows the person to work through their issues
psychologically. The therapist will help the person learn about themselves
and how they react in certain situations, allowing them to see why they may
feel anxious or depressed when triggered by something from their past.

Deep breathing is a technique to calm the body and mind and regain
calmness and focus. This natural relaxation method engages all major
muscle groups while calming the mind and creating a sense of self-control.
Unfortunately, many people turn to deep breathing techniques as natural
stress relievers without knowing the proper way to do it or how beneficial
they can be in anxiety disorders. One of the most effective forms of deep
breathing involves slow abdominal breathing.

How to identify emotional triggers

Emotional triggers are complex, and it is easy to misinterpret them. Here
are some tips that can help you identify and manage the emotional triggers:

1. Write down your thoughts and feelings.

Thoughts and feelings are important parts of emotional triggers. Write them
down in a journal, which will help you evaluate yourself and reduce the
stress of the emotions. Moreover, it will help you identify the triggers and
learn how to deal with them.

2. Stay away from unnecessary stressors.

To effectively deal with emotional triggers, stay away from unnecessary

stressors. For example, if you know that a certain situation is usually a
trigger for you, avoid being in that situation by all means. Even if it is
unavoidable, try to relax before entering the situation, so the emotional
trigger does not worsen the situation or affect you as much because of your
reaction to it.

3. Take time for yourself and ensure you enjoy life by doing what you love.

Stressful situations or people often trigger emotional triggers. To deal with

them, take time for yourself and do what you love to help you enjoy life and
relieve stress. Even if you cannot take time for yourself because of work or
school, try to make sure you are doing something that brings enjoyment to
your life by something that makes you happy and relaxed at the same time.
4. Improve your relationships with people who can help ease your emotional
triggers.

You can learn how to deal with emotional triggers by improving the
relationships with people who can help ease them, such as a friend or family
member willing to listen to how you feel and put things in perspective.
Talking to friends and family can help reduce anxiety and provide an outlet
to share what is happening. Moreover, it allows them to see who you truly
are instead of who you pretend to be.

5. Identify the cause

Individuals need to identify why they feel upset about something by

evaluating the issue thoroughly. This can help the individual realize the
importance of an event or situation and understand why they feel anxious or
depressed when triggered by it. It is also important for individuals to learn
how to react optimally in situations that might trigger an emotional trigger
to avoid being physically and mentally affected.

6. Stay in control of your emotions

There are many ways to reduce anxiety, such as deep breathing and
meditation. These can help you reduce stress by allowing you to stay in
control of your emotions so that an emotional trigger does not affect you as
strongly. Furthermore, these methods can help you identify your feelings
and deal with them effectively so that the emotional trigger will not affect
you negatively.

7. Learn to say no and be assertive

You need to learn how to say no when you cannot finish something so that
you will not feel overwhelmed by stress in your everyday life. Moreover, you
need to learn how to be assertive and stand up for yourself in the face of
anxiety triggers. You should also learn to ask for help, when necessary,
from someone who can provide you with the help you need. Always
remember not to be defensive when dealing with someone else's opinion on
the situation because it can hurt your feelings and make you more upset
because of the emotional trigger, which can result in a physical response as
well as an emotional response that can affect your day-to-day activity
negatively.

8. Learn to relax

Relaxation is an important strategy to reduce stress and manage emotional

triggers. There are many relaxation methods, such as deep breathing,
meditation, and yoga. In addition, relaxation is also helpful in reducing any
physical pain that may be experienced as a result of being triggered by an
emotional issue.

9. Connect with nature

You should also connect with nature and enjoy the beautiful scenery to
reduce stress and tension that can lead to trigger because of anxiety.
Nature can help you relax, de-stress, relieve tension, and reduce anxiety by
putting you in a good state of mind. Moreover, connecting with nature is a
healthy way to enjoy the wonders of our world, which can sometimes feel
overlooked by hectic schedules and stressful jobs or school life.

10. Do not avoid a trigger

You should not avoid a trigger when it is unavoidable, such as in social

situations that can be uncomfortable. When triggered by something, you
may feel overwhelmed by anxiety and depression, but do not avoid the
situation after thinking it through. If you have to go somewhere anyway, try
to be prepared with things that can help reduce anxiety before entering the
situation. For example, you can wear a meditator's hat or take deep breaths
before entering an environment or event that causes anxiety.

11. Relax before entering the situation or event

It is important to relax before entering an uncomfortable situation because

it can help reduce anxiety. You can take deep breaths, use a meditator's hat,
and listen to soothing music to help you relax before you enter an
uncomfortable social situation.

12. Try not to worry about what will happen

You should try not to worry about what could happen in that stressful event
or situation because worrying can bring negative thoughts and emotions.
When triggered by anxiety, individuals often focus on what might happen
instead of how to deal with the problem. Worrying about the issue will only
worsen the trigger because of increased stress and tension.

One of the best ways to control anger is by identifying your triggers so that
you know how to deal with them effectively. Unfortunately, work and school
are places where many triggers tend to occur, such as competing with co-
workers or students for a big project that has a large sum of money
attached to it; not getting what you want at work; experiencing personal
disagreements with co-workers and managers; or being teased by co-
workers and peers for things such as race, religion, gender identity, or
sexual orientation.

Before you can identify your response to a trigger, you must first identify
the triggers you may experience. You can learn about possible triggers by
talking to people who have experienced similar things and have learned
how to deal with them effectively. For example, when you feel upset about a
situation, consider what feelings it could bring you, such as anger or
depression. In addition, find out whether any triggers happen before or
after that event or situation when it causes stress and tension in individuals,
such as reading negative news reports on the internet or watching news
reports about national disasters affecting people worldwide.

Therefore, identifying your triggers is essential since it lets you know

possible situations that can affect you emotionally, mentally, and physically.
You can then take time to prepare yourself before entering a situation or
event that triggers your emotions. Moreover, learning how to cope with
emotional triggers will make you more capable of dealing with various
issues in your everyday life by avoiding anxiety or depression. First, you
need to know whether the trigger is simple or severe; once you know this,
you can decide on an appropriate strategy that suits your needs.

Lastly, emotional triggers are not something to feel ashamed about because
they are a normal response under certain circumstances. Always remember
that each person has their emotional triggers, so it becomes easier for
people to understand why they have different reactions and feelings when
facing similar situations.
Take a break from the situation if you feel stressed about a large project or
competition. It is important to take time to relax and reduce stress. Also,
prepare yourself before entering the situation so that you don't have to
worry about emotions caused by certain situations.

Use relaxation techniques such as meditation, deep breathing, and listening

to soothing music before entering stressful situations if necessary because
it can help reduce anxiety.

It would be beneficial for individuals dealing with stress and anxiety to try
all possible ways of managing their stress or anxiety even if they do not
work in a stressful environment or do not have access to a psychologist or
mental health professional at this moment in their lives.

How to identify your body’s response

To identify your body’s response to social situations, you can read about
various experiences people have had in their lives about their feelings and
emotions when they are put in the same scenario. This will provide useful
information on how individuals deal with stressful situations when asked to
perform or complete a certain task.

For example, when dealing with a stressful job, you may read stories of how
people deal with relationships at work and how they cope with their
performance pressure by reading positive and negative feedback from
others. Remember that responses to a task or situation can differ from one
individual to another.

You can also talk to other individuals who have experienced similar
situations to help you identify whether you are experiencing your body’s
response or an emotional trigger. Talking about your experience will let you
learn more about the social environment where it takes place for individuals
to grow and become more confident as they gain valuable experiences that
could improve their skills.

Therefore, these tips can help you identify your body's response:

1. Observe your body and emotions

Observing your body's response can be useful when you are stressed while
working. To do this, observe whether you feel anxiety or not while going
through the task or situation. Take note of how you feel after completing the
task, such as relaxing and having a good time with your friends and family.

2. Identify triggers

When confronted with stress in a social setting, it is important to identify

your triggers so that you can take steps to prevent such situations from
causing negative emotions. Try reading books online about individuals who
deal with similar situations in their daily lives about what works for them
and what does not when they have problems at work or school.

3. Do note-taking

Take note of your emotions or feelings when in a stressful situation at work.

These can include anxiety, depression, and anger. You should also
determine whether you felt any response before and after the stressful time
at work.

4. Go through your actions while dealing with stress

Because actions trigger emotions, it is important to conduct a self-analysis

by going through your actions or behaviors while handling the stress at
work or school. Ask yourself questions such as "What do I do when I
experience stress?" and "Why do I get stressed?” By understanding why you
feel frustrated with certain situations, you can identify what triggers you
consistently experience before and after stressful situations.

5. Identify possible solutions

When you understand your body’s response, you can identify possible
solutions for dealing with stressful situations. You can either look for ways
to reduce anxiety or try to avoid stressful situations altogether. If the
situation is too serious and persistent, you may need to seek a psychologist
or psychiatrist specializing in dealing with emotions like depression and
anxiety.

6. Remove distractions
Removing distractions will be a good idea if you are in a stressful situation
at work. This will keep your mind focused on the task at hand, allowing you
to reduce anxiety and stress and focus on the task without being distracted.
You can do this by working alone or turning off all internet devices.

7. Focus on one step at a time

When dealing with stress or anxiety in social situations, it is important to

focus on one thing only while doing so. For example, if you are studying for
an exam, focus only on the text you are reading and not the other things
happening around you, as distractions can keep your mind from focusing.

8. Control your breathing rate

When you feel anxious, stressed, or panic in a social setting such as work,
try to control your breathing rate. This will help keep your thoughts clear
while calming yourself down to keep stressful emotions away. Deep breaths
can do wonders in helping with stress and anxiety attacks during stressful
situations at work and school.

9. Stay positive

It is important to stay positive during stressful times. During such situations

at work, think about what you can do to improve it instead of dwelling on
the problems. If you are trying your best, do not think about failures or what
other people say about you because these can only cause negative emotions.

10. Be in control

If you feel stressed out at work, try focusing on what you can do to improve
it. For example, if your boss demands a project within a week while other
co-workers fail to finish their tasks, it would be a good idea to set goals and
think about completing them in time without sacrificing quality and
accuracy. You can gain positive results from your efforts at work and school
by being in control during stressful situations.

11. Establish a routine

It is important to establish a routine when dealing with stress and anxiety.

It can help you reduce anxiety and stress when you do the same things
before going to work and during stressful times at school or work. If you
continue the same routine every time, it will be easier to deal with stress as
unwanted thoughts will not often occur, which can bring negative emotions.

12. De-stress

If you are stressed out at work or school, try doing something that may take
your mind off. This can include listening to music, watching funny videos,
and doing something you enjoy, as these can distract your mind from the
stress.

A great way to manage stress is by using self-help books and listening to

relaxation music. These can help you stay relaxed, calm, and focused
throughout stressful situations, giving you more time and opportunity to do
the tasks.

Another helpful way of reducing stress is taking a walk or exercising before

entering a stressful situation. These activities help lower stress levels,
leaving you with a better mind for work or school.

Lastly, cultivate positive thoughts when dealing with stressful situations

because these reactions can benefit your body in numerous ways. Some
benefits include improved mental health, coping with feelings of worry and
depression, and reduced feelings of anxiety.

How to identify your thoughts

Identifying your thoughts involves acknowledging your feelings first, then
thinking about why you’re feeling the way you do.

It is important to identify your thoughts if you want to deal with stress

effectively. The following are five questions that will help you think about
how you feel:

a. What made me feel this way?

b. What else could I be doing?

c. Am I getting all my needs met in life?

d. How does my family view me?

e. What am I good at?

After you have identified your thoughts, write them down. Then, put these
aside and come back to them later. You may realize that they are
unnecessary thoughts or fears.

These tips can help you identify your thoughts:

1. Recognize your emotions

Instead of ignoring your feelings, you should recognize them. Writing down
how you feel and identifying the triggers is a good way to deal with stress.

2. Experiment to see what works best for you

There are many stress management techniques, and one will work best for
each person. Therefore, you should try different techniques to find what
works best.

3. Tell someone how they make you feel

Share your thoughts and feelings with someone close to help them
understand how they may affect you. This step might seem simple, but it’s
the key to understanding yourself better.

4. Identify your triggers

Triggers are things that cause you to feel stressed and anxious. Think about
where you feel negative emotions and write them down to identify your
triggers. Triggers may include bad thoughts when you see certain people,
smell scents, hear loud noises, or even at certain times of the day.

5. Observe your reactions

After identifying the three steps to identifying thoughts and feelings, try to
observe what happens in your head in stressful situations at work or school.
Note how these situations make you feel by writing down what happened
during stressful times at work and school so that you can overcome stress
easier later on.

6. Evaluate

After you have identified your thoughts, write them down and evaluate them
a few days later. Try to see if they are helpful or not by analyzing how they
make you feel and how you respond to them.
7. Never apologize for your feelings

There is never a need to apologize for your feelings because it is normal to

have negative and positive thoughts about certain situations in life. Your
emotions will keep changing for good and bad, so do not feel guilty about
thinking the way you do because other people understand that it is only
natural to think this way, even though it seems irrational sometimes.

8. Realize your feelings are not facts

Feelings can lead to thoughts that aren’t true, so it is important to separate

emotions from the factual reality of situations. Thoughts about how other
people think about you can be invalid, so you should never feel guilty for
being who you want to be and doing what will make you happy.

9. Accept your feelings

Accept your thoughts and feelings as a part of who you are because it may
seem difficult at times, but it is necessary if you want to manage stress
more effectively.

10. Take care of yourself

Dealing with stress is very personal, and you must take time to understand
yourself better. While trying to identify your thoughts and feelings, it is
important to focus on your physical well-being by drinking lots of water,
eating right, exercising, getting enough sleep, and having fun.

Identifying thoughts can be challenging for everyone, so be patient

throughout the process. Moreover, be persistent and keep up the good
work, as stress management will pay off in the end.

Anxiety is a part of everyday life, whether you're feeling anxious due to

something that happened in your life or regularly feeling anxious about
worry. Anxious feelings can be controlled through proper self-care, a
healthy lifestyle, and other coping strategies.

Once you have taken stock of your negative thoughts, managing them is
important. Here are ten tips that will help you manage them:

a. Practice positive thinking.

b. Be in the moment.

c. Learn how to quiet your mind.

d. Have faith in yourself and your abilities.

e. Get a good night’s rest.

f. Try not always be perfect; it’s okay to fail sometimes too!

g. Don’t blame yourself for things that aren’t your fault (i.e.: blame others
for their faults or not being perfect)

h. Don’t be so quick to trust others.

i. Practice breathing techniques for stress.

j. Get out and live your life, don’t spend all your time worrying about the
computer and with friends or family!

Using self-talk is a way to talk yourself into believing positive statements

about life in general and coping with stressful situations. Start by choosing
one negative thought and writing it down in a notebook or journal, being
sure to write it down in detail rather than just analytically saying it aloud.
Once you have written the negative thought, turn the thought into an
opposite positive statement that will help you cope with stress better.
 Why CBT works for anxiety
The premise of cognitive behavior therapy is that thoughts, rather than
external events, cause you to react with anxiety. If it seems like everyone
has anxiety these days, it could be because they are thinking a lot more
about their worries and the possible consequences of these worries. It is not
obvious on the surface, but this type of worry can lead to feelings of
helplessness and overwhelm that contribute to health problems like high
blood pressure and heart disease.

While CBT may work for some people in addressing chronic worry, many
people struggle with mental health conditions such as stress-related
disorders or bipolar disorder, where thoughts cannot be ignored because
they are overwhelming or unrealistic as obsessive-compulsive disorder
(OCD). This is where mindfulness training can help.

Mindfulness training and CBT complement each other in a mutually

beneficial way. Mindfulness is the ability to pay attention to the present
moment without being distracted by past or future events. Sound familiar?
That's just like one of the components of CBT: distraction techniques that
allow you to focus on your breathing to ground you in the present moment.

CBT may also help boost your ability to use mindfulness techniques
effectively and vice versa. Increasing your mindfulness skills may enhance
your ability to think through better options for solving problems and
removing compulsions rather than retreating into a dissociative state.

Mindfulness training can aid in improving your mental well-being using

cognitive behavior therapy. At first glance, CBT may seem like a rational
process that allows you to assess situations and then make decisions from
there clearly. However, while it does involve this thinking, CBT is more of a
process than a magic bullet solution. As such, it can be better compared
with mindfulness therapy than many other forms of treatment for anxiety
and depression.

Mindfulness training, on the other hand, can be applied mindfully while

working to eliminate unhealthy habits or compulsions that you may have.
Even if mindfulness seems like a passive activity and not something that you
can focus on while doing something else, it can help take your mind off of
overwhelming thoughts or the natural tendency of one's mind to judge
others based on their appearance and background rather than focusing on
what's important. You'll find that through practice, mindfulness will
eventually become a habit.

By extending the helpfulness of mindfulness to a situation where you can

experiment with CBT, your mindfulness skills can strengthen your ability to
think through things better. This is why many people with anxiety and
depression report greater success in thinking through their problems while
incorporating mindfulness techniques into their daily lives.

Mindfulness meditation and mindfulness techniques can help you better

cope with your anxiety symptoms because it brings your attention back to
the present moment rather than allowing your mind to wander and become
distracted by unimportant things.

While treating the underlying cause of your anxiety is important, focusing

on mindfulness can help you remove the "disguises" that prevent you from
thinking clearly about the world. For example, if a person is trapped in a
negative thought pattern, mindfulness can help them recognize this pattern
so they can deal with it appropriately. In addition, they may recognize that
these thoughts are associated with anxiety disorders or depression rather
than something that is factually true.

What does CBT do for anxiety?

Cognitive behavior therapy does more than teach you to distract yourself
from negative thoughts effectively. It also teaches you to recognize your
"triggers" to form a plan of action when these triggers are set off. This
allows you to remove the overall anxiety from an event or experience and
prevents triggering strong negative emotions.

CBT allows the recognition that you may have been using avoidance as a
coping mechanism for some time and teaches new coping mechanisms in
place of avoidance. For example, if talking about death may cause a person
to feel anxious, CBT can teach them new ways to cope with their anxiety
without avoiding the subject altogether and how they can best talk about
things when necessary. CBT aims to help you reflect on your thoughts,
feelings, and behaviors and learn how they contribute to the problem.
While it is not often used in mental health care centers today, CBT has been
a mainstream therapy since the 1960s. In addition, Charles Darwin and
other cognitive psychologists have also contributed greatly to cognitive
behavior therapy.

Cognitive behavior therapy can treat anxiety disorders by helping people

recognize that positive thinking doesn't necessarily mean you will feel
happy or calm. It can help people think more clearly about specific thoughts
and identify when those thoughts or behaviors are bringing them down in
the long run. CBT is a great tool to help people address their negative
thoughts and actively replace those thoughts with ones that feel more
helpful.

CBT works for anxiety by assessing the negative thoughts that cause stress
and anxiety and then teaching new ways to cope with these thoughts. CBT
guides you in the process of exploring your emotions and recognizing when
you get stuck in a negative thought pattern.

CBT is appropriate for people suffering from debilitating anxiety disorders

and teaches them new coping mechanisms to live healthy life while coping
with their disorder. People who have learned effective methods of coping
with their anxiety can also better recognize when they're slipping back into
old patterns and easily regain control over their thoughts.

CBT will teach you to recognize your triggers and how your negative
thoughts contribute to the problem simply by identifying them. It's an
important tool for anyone who suffers from anxiety disorders because it
impacts your thoughts and behaviors when they're unhelpful.

CBT is a good way to treat anxiety because it allows you to focus on what's
happening now without letting your mind wander. In addition, by helping
you recognize the triggers of negative thoughts, CBT can help you address
these issues directly.

CBT can also teach you to recognize when your negative thoughts are
taking you down a negative spiral that can keep you stuck in an unwanted
pattern. CBT helps people focus on the positive by giving them new ways to
look at their anxiety and their experience of it.
Cognitive behavior therapy is often effective because it addresses the inner
work of your brain and teaches new ways of coping with negative thoughts
and emotions. It also focuses on specific issues that cause anxiety and
teaches people how to approach these situations differently.

People who suffer from anxiety disorders or depression often have an

unhealthy relationship with their thoughts. The main focus of CBT is to
show people how to respond to their thoughts instead of letting the
thoughts control them. This is why CBT is a good tool for anxiety and
depression.

Cognitive behavior therapy uses a method known as exposure therapy to

help people process their emotions, thoughts, and experiences so they can
heal. Exposure works because by addressing the underlying problem
directly, you also address the symptoms of that problem. For example, if
you're afraid of dogs because your parents were bitten by one when you
were young, exposure therapy can help you face your fear head-on in a safe
environment and learn how to cope effectively.

CBT allows you to remove the symptoms of your anxiety by eliminating the
behaviors that may be causing it. It also allows for a deeper look at the root
cause of the problem so you can address it accordingly.

Cognitive behavior therapy can often help us understand why our thoughts
are so negative and how we can make them more positive. In addition, it
teaches you to recognize when your thoughts are causing anxiety.

It may be helpful to speak with a professional regarding cognitive behavior

therapy if you think it could be a good fit for your anxiety problems and
concerns.

One thing that CBT does is teach you to identify when a thought feels
irrational so that you can learn to respond with more positive thoughts and
actions. Cognitive behavior therapy can also help you slow down your
thoughts, and better handle them.

CBT is a great way to help people identify how their negative thoughts,
behaviors, and emotions contribute to the problem. In addition, it teaches
people new coping methods that are more effective than avoiding what may
cause anxiety.

Cognitive behavioral therapy is best known for treating the underlying

problems behind stress and anxiety disorders through recognizing your
thoughts and feelings and changing your actions in response to your
feelings. Moreover, cognitive behavioral therapy also enables you to
address emotions healthily so that they don't control your thoughts and
behavior.

Cognitive behavioral therapy targets the underlying issues that cause

anxiety to help people learn new coping methods.

CBT can also be used to treat depression and other mental health disorders
through each condition is best treated individually. Cognitive behavioral
therapy focuses on the client's thoughts, feelings, and behaviors and
teaches them how to make better decisions to help them feel better about
themselves and their lives. Cognitive behavioral therapy can take time, like
any other medical treatment. Therefore, sessions are scheduled on an as-
needed basis, although there may be follow-up sessions after the initial ones
if necessary.

How can I use CBT to control my anxiety?

Behavioral therapists are trained to identify your emotions and behaviors
contributing to your anxiety and take them in a healthy direction. They will
address these issues one at a time, which allows you to regain control of
your anxiety.

CBT helps people recognize thoughts, feelings, and behaviors that may be
causing their anxiety. CBT is an effective treatment for anxiety disorders
like generalized anxiety disorder (GAD), post-traumatic stress disorder
(PTSD), social anxiety disorder, panic attacks, and obsessive-compulsive
disorder (OCD).

Cognitive behavioral therapy can be helpful if you're suffering from any

mental health condition because it addresses the underlying cause of your
problems.
Cognitive behavioral therapy also targets thoughts and emotions that can
contribute to anxiety. It teaches you how to recognize your anxiety
symptoms and pressures you healthily.

CBT is a good treatment for anxiety disorders that focuses on the

relationship between thoughts, feelings, and behaviors so that you can
develop new habits and behaviors to help manage your symptoms
effectively.

Cognitive behavior therapy uses relaxation techniques, breathing exercises,

positive self-talk, and other methods of managing stress. Behavioral
modification is one of the most common ways cognitive behavioral therapy
treats anxiety. It targets the root of your problems by changing your
behavior instead of trying to change your thoughts alone.

Therefore, these tips can guide on how to use CBT to control anxiety:

1. Mindfulness: Learning to be present and in the moment is an effective

way of managing anxiety. Mindfulness helps people see their anxiety for
what it is - a passing emotion that may not mean what they think it means.

2. Focused attention: Focusing your attention on one thing can help make
you feel centered and less anxious. You should focus on everyday things like
your breathing, your feet hitting the ground, or something other than
anxious feelings or emotions.

3. Relaxation techniques: Relaxation techniques can help you regain control

of your anxiety symptoms and behavior by helping you manage stress
physically and mentally.

4. Distraction: Distraction can be very helpful in managing anxiety.

Distracting yourself by listening to music, reading a book, taking a walk,
calling a friend, or meditating are all ways of helping you calm down and
gain a better perspective.

5. Try hard to be positive: Positive self-talk is key in managing anxiety

because it helps you change negative thought patterns into positive ones
and change your behavior accordingly. Moreover, positive self-talk helps
you see your anxiety as a passing feeling that you can learn how to manage.
6. Look at what makes you anxious: When you realize the things that cause
you to stress, it's easier to handle them and think more positively. Make a
list of everything that causes you anxiety. As you respond to these things
more positively, your anxiety symptoms will decrease because your negative
thoughts will stop controlling your behavior.

7. Take care of yourself: Managing your symptoms and learning new coping
methods takes time, work, discipline, and patience, so be sure to treat
yourself well. Don't beat yourself up if the process takes longer than
expected. Remember, you're trying to change your life, so it's okay if it
doesn't happen immediately. Be proud of your accomplishments, and know
that you're learning to manage your anxiety by taking small daily steps.

8. Talk: Talking doesn't just mean visiting a professional counselor or

therapist weekly. Talking can also include talking with family, friends,
coworkers, etc., and sharing what's going on with you healthily (not
complaining or criticizing). You may want to try journaling alone or with
someone interested in helping support and encourage you along the way.

9. Practice: Practicing and learning new coping techniques is just as

important as the others on this list. Knowing what works for you and what
doesn't takes time and practice. Don't give up! Take notice if you feel
stressed, anxious, or become obsessed with something that you think is
causing your anxiety.

10. Look after yourself: When you're feeling overwhelmed with stress, it's
easy to forget about your needs as a person. Make sure to get enough sleep,
eat well, exercise regularly, go out for frequent walks or runs outside, or
take a hot bath once in a while! Get some fresh air by breathing in the wind,
or do some yoga or meditation.

11. Seek help as needed: It's important to seek professional counseling if

you feel you need it. Working with a therapist can let you talk about feelings
and emotions you may have previously avoided.

12. Have fun: Life is too short not to get outside your comfort zone and have
fun! Go out with friends, volunteer, socialize in public, or try something
new, like learning how to play an instrument or dance. The most important
thing is that you take care of yourself and enjoy yourself so that you stay
healthy and happy!

13. Be yourself: Being comfortable in your skin is key to success. Don't

compare yourself with others; remember that it's okay not to have answers
or solutions immediately. The point is to keep moving forward even when
you don't know where you're going.

14. Take action: Don't just think about things - take action! Start by making
a list of what you would like to change in your life, and then seek the help of
friends, family, or professionals as needed. Getting started on changes will
significantly affect how you feel and how much control you feel over your
anxiety symptoms!

15. Get out of the house: If you spend most of your time alone at home, it's
important to be around other people and socialize! The more you get out
and do new things, the less anxious you will feel because your mind won't
feel like it's constantly stuck in a rut.

16. Practice: Don't stop practicing these tips once you feel better because
continuing to practice will help build up your self-confidence and make
change easier with time.

17. Learn from mistakes: If something doesn't work or you make a mistake,
learn from it and move on. Remember that mistakes happen but learning
from them matters most in the end.

Many methods allow CBT techniques for treating anxiety disorders

effectively in clients with a higher level of thought processing and
concentration, for example, giving homework that the client completes
before subsequent sessions or asking them to carry out tasks between
sessions e.g.

The impact of fear and panic

The impact of fear is an automatic pattern of responding to danger, which is

perceived as a threat to the person's well-being and influenced by the
content of a fearful thought. Panic attacks trigger panic sensations in
vulnerable individuals who live with anxiety disorders. This triggers the
person's reaction and alertness. Fear can be induced by certain stimuli in
situations that are threatening to people (danger cues), such as stairways,
elevators, bridges, and driving under bridges. The response to threatening
situations depends on how effective the person believes they are at coping
with those situations (self-efficacy beliefs). The challenge for CBT is
creating or enhancing motivation for change.

The cognitive model of panic disorder is well established in clinical and

research literature. According to that model, panic attacks manifest a
dysfunctional response learned by sufferers to cope with the anxiety
naturally associated with certain situations (for instance, being in a
situation from which it would be difficult or embarrassing to escape).
Situations that result in this feedback are called "goals." People with panic
disorder are conditioned to respond incorrectly when they find themselves
in threatening situations because they fear that intense anxiety and physical
symptoms will be experienced if they don't get away quickly. The panic
attack consists of the feared sensation plus a strong fear response, whose
only function is to prevent the person's actual exposure to feared public
situations.

Cognitive behavioral therapy helps to counter the effects of panic by

teaching patients that their responses to situations are not catastrophic and
do not need to be avoided. People are taught to ask when they panic, "What
is the worst that could happen?" Since nothing catastrophic happens in
most situations that trigger anxiety in people living with panic disorder, it
often follows that the answer is nothing at all or something that can be
readily endured. For example, flight initiation may be accompanied by
shortness of breath and an increased heart rate. The sufferer may believe
these sensations indicate a serious illness, only exacerbated by
catastrophizing about their symptoms (e.g., "I feel like I'm going to die!").
However, the anxiety and other unpleasant sensations accompanying panic
attacks are usually not life-threatening. Inventing a catastrophic event does
little to help the sufferer in real life. This can be overcome by keeping a re-
evaluation of all of one's prior experiences in mind (the so-called "reality
testing"). The goal is merely to recognize that panic attacks do not lead to
catastrophes and that panic is a response to a feared situation, which is
often not at all dangerous. Note that this use of thought testing does not
mean one should be fatalistic about their health. If they had a heart attack,
they should seek help. Even though the sensations of a panic attack are
unpleasant and terrifying, what is feared is not dangerous.

The cognitive-behavioral model proposes that people with panic disorder

misinterpret harmless body sensations as signs of imminent death or
catastrophic illness. This leads to an immediate increase in anxiety (a panic
attack) which makes the person hypervigilant to bodily sensations and
provokes them to administer emergency response behaviors such as fleeing
or avoiding situations where anxiety symptoms are predicted to occur.
These symptoms are believed to be maintained by the mistaken belief that
they prevent the adverse event and keep it at bay. This hypervigilance
maintains and exacerbates the problem, in which people are not exposed to
situations where they can learn that their anxiety symptoms are not
harmful. Relative to this model, cognitive-behavioral therapy aims to reduce
misinterpretations of harmless bodily sensations and decrease maladaptive
emergency response behaviors.

The fight-or-flight response during a panic attack is similar to that during a

traumatic event in which an individual perceives themselves to be
threatened with mortal danger. The American Psychiatric Association, the
National Institute of Mental Health, and the American Academy of
Pediatrics have identified numerous therapies for panic attacks. A type of
therapy called cognitive behavioral therapy (CBT) is particularly effective.

Cognitive behavioral therapy (CBT) is a short-term counseling treatment

that helps people change their thoughts and behavior by teaching them to
view their world more positively to help them deal with difficult situations
more constructively. In addition, CBT resets the reaction pattern of chronic
anxiety, allowing the body to respond normally to stressors without
resorting to fight-or-flight responses or maladaptive avoidance.

CBT for panic attacks is a short-term counseling treatment that helps

change irrational thoughts, overcome fears and phobias, accept oneself and
one's surroundings, and learn how to modulate responses to stress. CBT has
been found to help many adults deal with their fear of bodily symptoms and
unfamiliar situations in everyday life. CBT aims to help the person gain
control over their emotions by helping them recognize their irrational
thoughts as irrational thoughts rather than facts. CBT exposes the person to
the belief that they can control their feelings and have a positive view of
themselves regardless of situations. It is also hoped to allow the person to
realize they have a high responsibility for changing difficult situations.

Propranolol is effective in treating panic disorder when administered

immediately following a panic attack. Although its effects do not last
forever, they are long-lasting enough to give panicked individuals time to
defend themselves and flee the situation where the panic took place. In
some cases, patients may not experience immediate relief from symptoms at
first but usually experience them within the day or two following the dosage
of propranolol. Another study involving propranolol administered before
exposure therapy (as opposed to immediately after) did not reduce
symptoms as effectively. This may have been due to the timing and dosage
used. These findings suggest that propranolol should be taken at the first
sign of symptoms.

Propranolol may work by decreasing the activity of the amygdala or helping

the subject control their sweating or both. It is thought that propranolol
helps patients control their symptoms due to its ability to be metabolized
into a beta blocker, which tightens blood vessels and reduces physical
responses to emotional stimuli. Studies involving propranolol have shown it
to be effective in treating panic attacks immediately following them (as
stated earlier) and throughout treatment.

The cause of anxiety

The cause of anxiety attacks is a combination of genetic and environmental

factors. The disorder is thought to have a genetic component, meaning that
biological and environmental factors may contribute to the development of
the disorder. But an anxiety attack can also be triggered by a traumatic
event, such as receiving news of a divorce or losing a loved one.

Panic attacks are common among those who have been diagnosed with
panic disorder. According to the Anxiety and Depression Association of
America (ADAA), about two-thirds of people with panic disorder develop
irrational fears (phobias) during their life. The ADAA describes phobias as
unrealistic or exaggerated responses to situations involving intense fear or
discomfort. These fears can cause people to avoid the situations that trigger
their panic attacks.

Psychological factors can also play a role in developing panic attacks and
other anxiety disorders. For example, studies have found that when
compared with those who had not been diagnosed with an anxiety disorder,
individuals who had responded to feeling needed security by seeking help
from psychologists or psychiatrists were at greater risk of later
experiencing anxiety or tension-related attack. This suggests that helping
someone feel secure can trigger a panic attack.

Research has shown changes in the brain, particularly in the amygdala,

during states of anxiety and fear. For example, studies have shown
increased amygdala activity when people are threatened. These changes in
brain activity are believed to result from long-term (beginning as early as
infancy) exposure to stressful events and environments, which may include
traumatic experiences.

The result is that many patients experience anxiety without any identifiable
cause or trigger. You can only hope that your symptom is triggered by a
specific event, such as a car accident or public transit incident – usually, a
stressful one that leaves you shaken up by the symptoms of your panic
attack.

Anxiety is a normal response to danger and stress, but unlike fear and other
emotions associated with danger, anxiety attacks are often unexpected and
unprovoked. In contrast, to fear, the hallmark characteristic of anxiety is
having feelings of apprehension or dread about an upcoming event or
situation that is perceived to be no threat. Anxiety attacks usually occur
“out of the blue” because they are not associated with a specific situation
around which nerves can be calmed down.

The only treatment proven effective for panic disorder is cognitive

behavioral therapy (CBT), a specialized type of psychotherapy. CBT teaches
you different ways of thinking, behaving, and reacting to the symptoms of
panic disorder. CBT aims to help you recognize and change the negative
thoughts, emotional responses, and behavior patterns that affect your
ability to function.
CBT has been shown to help improve various symptoms associated with
panic and other anxiety disorders. CBT has also been shown to help lessen
the frequency of panic attacks when combined with pharmacotherapy. In
addition, CBT has been shown to help improve outcomes when combined
with a treatment such as exposure therapy.

Adolescents and children can benefit from short-term psychodynamic

psychotherapy, but only if there are no clear signs of dangerousness, such
as attempts at suicide or self-harm.

When panic attacks occur infrequently or are isolated events, a therapist

may suggest that the person with panic disorder focuses on coping
strategies such as relaxation training, cognitive restructuring, and exposure
therapy. Relaxation training involves beginning a hierarchy of graded
exposure to situations that might cause panic, starting with situations that
are likely to cause less anxiety and progressing towards more challenging
situations.

Cognitive restructuring helps the person challenge irrational beliefs about

the self and the world by developing more realistic ways of thinking. A
specific technique is called "thought stopping." Despite not being supported
by empirical evidence, cognitive restructuring is still used in treatment
today. For example, it is considered equally effective as behavioral therapy
when treating an isolated panic attack.

Exposure therapy involves exposing the person with panic disorder to

situations or environments that cause anxiety in a controlled manner while
being accompanied by trained therapists. This can involve exposure to
different situations intended to trigger anxiety and facing the individual's
fears about such situations. Exposure to these situations without supportive
people can cause more extreme panic symptoms.

Psychoeducation is recommended to prevent panic attacks in children and

adolescents (10–18 years). There is evidence that adolescents who are
actively informed about their condition and what they can do about it may
be less likely to have a period of intense fear and distress when they first
begin to experience symptoms. Parents, guardians, and teachers are good
resources for information. In addition, anxiety can be managed effectively in
children and adolescents by establishing ongoing relationships with the
child and family that have a positive and reassuring effect. This is done by
actively ensuring that the place, time, and circumstances are as comfortable
as possible. In addition, care should be taken to ensure that environmental
conditions are adequate to minimize exposure to hazards such as smoke or
second-hand effects of drugs, alcohol, or volatile chemicals.

Panic disorder can occur with other psychiatric disorders. It frequently

occurs with depressive disorders, particularly major depressive disorder
(MDD), which mild depression-related setbacks may trigger. It is also
common during manic episodes of bipolar disorder. In addition, it has been
diagnosed comorbidly with a generalized anxiety disorder (GAD), where the
patients may constantly worry about the future and have difficulties in
routine activities.

Anxiety disorders are associated with major functional impairments. The

likelihood of panic disorder and agoraphobia is estimated at 10% to 23%.
The risk is higher among women than men. Agoraphobia without panic
disorder produces an increased risk of being unable to leave home alone
due to fear of experiencing panic symptoms. Panic disorder can be
effectively treated with various interventions, including psychological
therapies and medication, which can relieve symptoms and help prevent
future episodes.

Benefits of CBT for the long-term anxiety

There is limited evidence to support the use of CBT as a first-line treatment

for anxiety disorders in adults. However, CBT can be an effective
component of treatment in adults and adolescents with anxiety disorders.

One meta-analysis concluded that CBT is more effective for reducing

anxiety than other treatments, including pharmacotherapy, recommended
for treating GAD. In addition, treatment duration was significantly longer
with CBT than with medication alone in the short term. Three randomized
controlled trials compared treatment as usual (TAU) to a combination of
TAU and CBT (CTST) for anxiety disorders. Two studies indicated that CTST
improved anxiety symptoms more than TAU. Although the third study
reported no difference between the groups, this may have been due to
problems with the randomization process.

Some people have only a single attack and then never have another one,
while others have many attacks in a short period. Some people have
recurrent attacks that come on suddenly and last only a few minutes, but
others experience anxiety that lasts for weeks or months before they go
away.

Agoraphobia can develop suddenly in children or teenagers due to

situations that usually do not cause panic. The condition usually lasts at
least six months but is often recurrent and can continue into adulthood.

Panic disorder and agoraphobia are a basis for developing panic attacks in
conditions such as social anxiety disorder, obsessive-compulsive disorder
(OCD), post-traumatic stress disorder (PTSD), and phobias. When this
occurs, the main symptom is recurrent panic attacks that may involve all of
the symptoms previously described in this book or some combination
thereof. These attacks are temporary and can end in a few minutes or last
months. Psychiatrists describe this as a temporary condition that causes
significant impairment in functioning due to the intensity of the symptoms.
When the individual is experiencing distress during an attack, the diagnosis
of panic disorder is made.

Therefore, these are some of the benefits of CBT as a treatment method for
long-term anxiety:

a. It is considered a highly effective treatment for anxiety disorders.

b. CBT is effective in the long-term treatment of anxiety disorders.

c. It has a lower dropout rate than other treatments such as

pharmacotherapy (e.g., antidepressants and benzodiazepines).

d. It allows the patient to learn coping skills that can be applied even after
the treatment ends. Reports indicate that these skills can be transferred to
other types of anxiety disorders, including post-traumatic stress disorder
(PTSD).
e. It has also been shown to be an effective component of a combined
treatment involving pharmacotherapy, often prescribed to treat anxiety
disorders.

f. It has been reported to be an effective treatment in adults, children, and

adolescents.

g. In addition, CBT is considered a treatment of choice for many anxiety

disorders.

h. CBT has also been effective in treating depression and generalized

anxiety disorder (GAD).

i. It leads to restoring the functioning of patients affected by panic attacks,

leading them back to the activities they were able to do before having panic
attacks.

j. Due to its effectiveness, high client compliance rate (the patient must
follow all sessions closely and attend all appointments), and low dropout
rate compared with other treatments, it is often considered a first-line
treatment option when no other treatments are available, or they fail.
 Treatments:
Cognitive Behavior Therapy for Depression is psychotherapy that looks at
how the patterns of thoughts and beliefs are related to depression. This
includes thinking too much about the negative events in our lives or not
thinking enough about positive events. A key element of cognitive behavior
therapy is identifying distortions in our view of ourselves, others, and our
world so we can change things.

The National Institute of Clinical Excellence (NICE) in the UK has

recommended that CBT be used for mild to moderate depression and
prevention (to keep the number of people who become depressed low).

Cognitive Behavior Therapy should be thought of as a skill to be learned. It

is a set of skills that you can use to solve your problems. So while it will
have time limits in a clinical setting, it will have no time limits if you learn
how to use it on your own.

Social anxiety and CBT

CBT treats social anxiety through a process of education and awareness of
the nature of anxiety and its symptoms. Individuals are encouraged to
become more aware of their anxiety symptoms, identify the thoughts and
situations that trigger them, and learn how to maintain control.

Researchers have found that CBT effectively reduces social phobia, while
other studies show that it is comparable to pharmacological treatment
concerning effectiveness.

CBT is an effective treatment for people with a diagnosis of schizophrenia.

It helps patients interpret their experiences in more realistic terms, identify
distorted thoughts that lead to emotional distress, and develop coping
strategies to deal with distressing feelings or situations.

Social anxiety and CBT are helpful in the treatment of borderline

personality disorder (BPD). Through these skills, CBT helps patients
develop a sense of self, feel more in control over their emotions, lead more
fulfilling lives, and improve relationships with others.
CBT also treats eating disorders like anorexia nervosa and bulimia nervosa.
By helping patients recognize their unhealthy thoughts and develop
healthier behaviors, CBT can help patients overcome their eating disorders.

Moreover, social anxiety is a key feature of a generalized anxiety disorder

(GAD) and post-traumatic stress disorder (PTSD). CBT is effective in
reducing social anxiety. In addition, patients who were treated with CBT
experienced a significant reduction in avoidance symptoms.

The process of using CBT for social anxiety involves:

a. Self-monitoring of social anxiety: Patients are encouraged to become

more aware of their symptoms of social anxiety and monitor their responses
to specific situations such as public speaking, eating in public, etc.

b. Cognitive restructuring: This involves identifying distorted thoughts that

lead to the patient's negative feelings and developing more realistic ways of
thinking about the situations.

c. Behavioral experiments: Patients are encouraged to test their unrealistic

thoughts through a series of behavioral experiments in this step.

d. Reducing safety behaviors: The fourth step involves reducing safety

behaviors, such as distracting oneself from an imagined negative evaluation
by focusing on something else or leaving an uncomfortable situation.

e. Exposure to feared situations: Within a controlled setting, patients are

encouraged to experience their feared social situations without using safety
behaviors and exclusively through a long-term goal-oriented perspective
("arrivederci").

Social anxiety and cognitive behavior therapy are effective in reducing

depression. The underlying assumption is that depressed individuals
experience negative events in their lives as more intense than healthy
individuals do. For this reason, CBT tries to teach people how they think
about these events and change their thoughts so they are less intense. This
process involves CBT skills like rehearsal, role play, and imaginal exposure
(putting ourselves into a situation where we predict how we would feel).
This can also be used to prevent depression by reducing the intensity of
negative events.
For example, some people think: "Nobody likes me," and they are afraid
that no one would like them. Cognitive behavior therapy would try to
change this thought into a healthy one. Therefore, the treatment starts by
considering why it is important to make the person you treat to feel like
others like them. The focus is to ensure they understand what it means to
be liked.

CBT can alter how people view themselves by focusing on the benefits of
social relationships, such as feeling loved or valued.

Techniques that are being taught must be ones that can fit in with all
situations. Therefore, if a person has had some personal experience of using
CBT techniques and it is not working, they need to be taught new
techniques and retested. If problems still occur, referring them to their GP
for medical assessment is best.

CBT and Negative Core Beliefs (NCBs)

CBT is used to treat individuals who have had traumatic experiences in
their lives, such as cancer patients, soldiers, and victims of sexual abuse.
CBT is useful because it can help patients develop healthier behaviors to
relieve the distress caused by their traumatic experiences. In the case of
cancer patients, one of the coping mechanisms that help reduce anxiety
involves NCBs. NCBs are beliefs about oneself (such as I am worthless) or
beliefs about the future (such as I will never get better). People use NCBs to
make sense of stressful situations, but in some cases, they can also increase
feelings of helplessness and hopelessness and become harmful. There are
two ways in which CBT helps treat individuals with NCBs, and the first is
that it reduces their sense of helplessness. A study shows that after eight
sessions of CBT, participants experienced less hopelessness and
helplessness than those who did not receive CBT.

The second way CBT addresses NCBs is by helping the individual

reconstruct the meaning of their experiences. When individuals go through
a traumatic or potentially traumatic experience, they can cope with it using
two different methods: via constructive (meaning-making) or destructive
(meaning-maintaining) processes. The latter involves a person having
negative thoughts about themselves or their environment and then trying to
find a way to maintain these negative thoughts. The constructive way of
coping with a traumatic experience is by having positive thoughts about the
environment or themselves. CBT is useful because it helps individuals to
reconstruct their experiences and constructively recover from trauma.

The benefits of CBT have been demonstrated for people suffering from
mood disorders such as major depression, bipolar disorder, and dysthymia.
The most noticeable effect of CBT is an improvement in mood, but
generally, functioning and quality of life are often improved. This is partly
due to the direct effects of CBT on mood and functioning, but also indirect
effects such as increased motivation, more activity, and more positive social
interactions.

For individuals with bipolar disorder, the most established and evidence-
based way of preventing a depressive episode is to reduce or eliminate
drinking alcohol or using drugs. Because both substances have a depressive
effect, reducing intake often helps to prevent depression. Unfortunately,
some individuals with bipolar disorder are unable and unwilling to reduce
their substance use.

The main aim of CBT for substance misuse is to reduce the frequency and
amount of substance use and any associated problems such as health issues,
unemployment, or relationship problems. Therefore, the first step in
treatment involves identifying goals related to reducing usage or stopping
altogether. A therapist will then help the person identify how their thoughts
about using substances might maintain their problem. They can then work
on reducing the frequency of substance use and sabotaging their thoughts.

CBT is useful in treating adolescents with depression because it is a short-

term therapy that gives young people the skills to deal with their depression
in the future. Most teenagers that suffer from major depression will recover
within a year. Still, they may suffer another depressive episode later in life,
so they must be given effective tools to help them through these times. CBT
can be used to help teenagers and children by teaching them how their
negative thoughts affect their emotions and behaviors. CBT techniques
involve thought-stopping (a way of controlling negative self-talk) and
thought replacement (a way of replacing negative thoughts with positive
ones).
For example, a patient with lung cancer has never smoked, but she might
believe that her cancer is caused by tobacco. This belief may make her feel
guilty, depressed, and worthless (i.e., I am worthless because I gave in to
smoking, my cancer is my punishment for smoking, and I will die because of
it).

CBT would first try to assuage the patient’s guilt with facts (such as tobacco
causes certain types of lung cancer but not all types) and then challenge the
patient’s negative thoughts (such as if you didn't smoke, you wouldn't have
this type of cancer anyway).

How to treat depression with CBT

Depression can be treated with CBT. First, it is important to understand
that depression is a common condition, and CBT can be used to treat mild to
moderately depressed people of all ages. However, CBT has become the go-
to method for treating depression when it occurs in older adults. Studies
have shown that older adults who received CBT were more likely to
experience clinical improvement than those who received other types of
treatment. However, once again, compared to the general population, older
adults are less likely to receive help for their depression due to challenges
in access and availability of services (such as financial challenges) and
because they have a higher risk for misdiagnosis or medication problems.

CBT has also been used in treating anxiety disorders in children. Any
individual with an anxiety disorder can benefit from this type of therapy,
and recent studies have shown that it does help with the generalization of
learned skills to everyday situations as well. It is not just useful for the
treatment of children but also for the treatment of individuals who have
panic attacks and other chronic anxious states.

For instance, CBT effectively reduced symptoms of depression and anxiety

after a person experienced a traumatic accident that left them hospitalized.
Other studies have found that certain techniques, such as stimulus control,
reduce symptoms of anxiety disorders, including social phobia, generalized
social anxiety, and panic attacks.

CBT is still used to treat people living with dementia, although it may not be
the most effective approach. By increasing awareness of the symptoms and
reducing exposure to negative social situations and the environment, CBT
can help decrease the risk of depression and other forms of psychological
distress. However, some findings suggest that depression significantly
predicts functional decline for individuals with dementia. Therefore,
treatment of depression in people with dementia requires careful
monitoring for suicidality and other safety concerns.

Researchers have found that CBT may be a helpful tool as early as

pregnancy for women who have or are at risk for experiencing depression
during their pregnancy. CBT was found to improve the number of anxiety
women experience throughout their pregnancies, and it also helps them to
feel more prepared for their child's life after birth. It also helps them to
understand the different types of depression and anxiety. This form of CBT
can be especially helpful for families with a history of depression because it
can make them more aware of their symptoms, which may help them
recognize the signs earlier. Additionally, it also helps women to prepare
themselves for postpartum experiences better.

In many cases, CBT is used in conjunction with medication or taken after

some time on medication. CBT has significantly improved the outcomes of
those receiving anti-depressant treatment when treating course one
(moderate) depression. However, these findings must be interpreted
cautiously because they only show an association between treatment and
improved outcomes; this does not prove that CBT causes improvement by
itself. For instance, other forms of psychotherapy also claim to lead to an
improvement in depressive symptoms, yet research has shown that there is
no significant difference between the different treatments.

This evidence suggests that CBT is not necessarily a better treatment for
depression. Certain studies have compared CBT to other types of cognitive
therapy or have analyzed the mechanisms behind CBT and have found that
the improvements from CBT are mostly due to exposure and response
prevention. This study found that exposure done systematically to expose
people to feared situations without giving in to a coping mechanism (for
example, exposure replaces avoidance) had most of the long-lasting effects
on people suffering from anxiety disorders.
 CBT for anger problems
Although every CBT therapist uses a different technique, here is a
description of one approach.

Several techniques can be used to treat anger problems: cognitive defusion,

here-and-now, and relaxation. Cognitive defusion is altering negative
thoughts by using more realistic ones. Here-and-now techniques include
empathic communication and compassionate responding. To help relieve
anger in people with depression, it is important to teach them how to put
their own needs behind those of others by criticizing or not accepting
others' needs. Rather than focusing on how angry they are and how they
want others to respond or behave, it helps them focus on what they want
instead. Relaxation techniques, such as progressive muscle relaxation or
guided imagery, are also quite effective in releasing pent-up anger.

People struggling with anger issues can try to follow healthy steps to avoid
and de-escalate anger. One of these ways is avoiding certain people or
places where they know they will get angry. Another way is by recognizing
how alcohol or drugs can cause people to become angry and avoid them. In
addition, taking a time-out from situations where people get angry can see
them react more healthily than when they stay involved in the situation.
Finally, people with anger problems need to avoid using violence or
intimidation to respond when angry. These actions can lead to violence or
bullying against themselves or others, especially children.

A clear expression of grief needs to be honored and attended to by the

person grieving for a person's grief to resolve. People commonly express the
grief they are experiencing without the conscious awareness that they are
doing so. When there is a loss, often no one sees it coming, and when it
happens, there is often shock and denial. This can lead to a difficult
experience for the individual who has experienced this loss and those
around them. Both individuals who have experienced a loss and those close
to them may have difficulty understanding how someone can suffer such a
traumatic loss. When grief is experienced, the individual who has
experienced the loss will usually have strong feelings towards it and how it
has affected them.
For someone to deal with their grief, it is common for people to try to avoid
or distract themselves from their feelings. This can be very difficult for a
person, as they may face many daily challenges that may cause them to
become overwhelmed. People experiencing this kind of grief need to find
ways to cope with these emotions healthily. One of the ways someone can
cope with their emotion is by exercising or doing something physical. This
activates the body's relaxation response, which helps someone calm down
and understand what they are experiencing.

The grieving process can be very different for each individual. Some may
want to express their feelings or talk about the loss, while others may not.
While talking about it with someone who has experienced a similar loss,
such as a therapist or family member, may help a person feel support and
understanding for themselves. This can be very helpful in helping them
work through their grief. In cases where people cannot say what they are
experiencing, writing down their thoughts and feelings can help both
individuals understand what they are going through and give them a way to
cope with these emotions.

It is common for individuals who have experienced a loss to be angry with

God during this time. Anger is commonly displayed when someone who has
experienced a loss feels that there has been an injustice in the world. This
difference can be an important way for people to express their grief, as they
may feel angry toward God, but this anger is more directed at the world's
injustice than towards God. Many people who have experienced a loss feel
angry at God due to the unfairness of life and how unfair it can sometimes
be. This anger will usually subside when people forgive themselves and
others after experiencing such trauma as a loss.

How to overcome negative emotional habits with CBT

Changing negative emotional habits such as feeling stuck in depression can
be challenging, especially if you are not used to doing so. However, if your
negative emotions are closely linked to a habit that helps you cope with
them and feel better about the situation, then it is likely that changing this
habit will help you a lot. For example, if an individual is socially less active
because they fear being judged by others, changing their social habits can
make them feel better about themselves. The benefit of this approach is that
the individual does not need to abandon their old habits completely but
instead can move them into a new, more positive side instead of being stuck
in the negative side. For example, if the individual is stuck in feeling stuck
and worried that everything is going wrong, they can try to move this worry
into a more positive emotion, such as being grateful.

In CBT, clients do not need to feel guilty about their emotions. It is the
therapist who assesses what causes the client's emotional problems. The
therapist helps clients identify their triggers, situations, or events that
cause them emotional reactions. They also help clients recognize common
misconceptions about emotions by explaining how negative emotions lead to
destructive actions through patterns of thinking and behaviors. People can
learn from their mistakes, develop new ways of coping with negative
emotions, and become more effective at responding to them.

CBT helps clients identify the situations that trigger negative emotions and
how these actions are linked to their emotions. CBT also helps people with
anxiety disorders focus on the present moment because many are prone to
worrying about the future or regretting the past. In addition, many people
with depression tend to dwell on negative thoughts, which can lead to
depression. Therefore, these individuals must focus on positive thoughts
and things they enjoy to become more emotionally balanced. Psychologists
have found that cognitive therapy can effectively treat certain disorders
such as depression and can be used as an alternative or supplement to anti-
depressant medications. CBT is also effective in depression, anxiety
disorders, and other disorders.

A major advantage of cognitive therapy is that it can be used to treat a wide

variety of different mental health issues and disorders. For example, people
with mood disorders can experience a broad range of emotions and distress.
Cognitive therapy helps individuals identify the situations that cause
negative emotions and lets them know how they can use positive thoughts
or behaviors to deal with these situations. Therapists also help clients
recognize their irrational beliefs, which may contribute to negative
emotional reactions. These irrational beliefs usually cause great distress
because they interfere with the individuals' ability to make healthy
decisions regarding their emotions and behavior.

How to treat sleep problems with CBT

In general, insomnia is a sleep disorder characterized by a chronic and
recurring inability to fall asleep or stay asleep at night. However, insomnia
may be characterized in different ways, such as difficulty initiating or falling
asleep without other sleep apnea symptoms, frequent waking during the
night or early morning, frequent daytime naps, and excessive daytime
sleepiness.

Sleep deficits can negatively affect performance in various facets of life. For
example, difficulty sleeping interferes with regular activities and
responsibilities at school, work, and home. In addition to health-related
problems (e.g., cardiovascular disorders) that may develop from insufficient
sleep, poor sleep quality may cause a person to have negative feelings
throughout the day (e.g., fatigue).

The cognitive behavioral therapy (CBT) technique must be used to treat

insomnia. This involves helping the individual identify why they have
difficulty sleeping and developing strategies to help them sleep. Many
people with insomnia complain that they cannot fall asleep and think it is
normal. However, this should not be normal for someone in good health
since most people with healthy bodies can sleep well when necessary.

A treatment for insomnia consists of discovering what causes the person's

thoughts about sleeping and how these thoughts cause them to feel
physically tired. Some common causes of an inability to sleep are poor-
quality sleep, anxiety, stress, and problems in social situations (e.g., having
a job). As a result, insomnia is usually caused by a combination of different
factors. More specifically, there are two types of insomnia:

CBT can be used to treat both types of insomnia. The difference between
the two is that people with sleep initiation problems (difficulty falling
asleep) tend to worry and think, "What if I fall asleep?" or "I can't do this,"
or even "What if I don't get any sleep?" while they try to fall asleep. This
kind of thinking makes them anxious, negatively affecting their ability to fall
asleep quickly.
To treat sleep initiation problems (not falling asleep), it is important to have
the patient recognize that they can go to bed at a particular time with
anxiety or stress. Then, they would tell themselves: "I am okay, I don't have
to worry about sleeping, and I will be okay." This kind of thinking is called
catastrophizing; many people cannot do it because they think it is
impossible. However, this way of thinking is a matter of degree; all people
are capable of doing something when they are stressed out and anxious.

In contrast, people with anxiety disorders that bother their ability to fall
asleep (sleep continuity insomnia) tend to worry about their children, the
health of a relative, or the details of the next day. They also worry about
work or even their future and what will happen. These repetitive thoughts
occur many times during the night and can prevent them from having a
relaxing sleep. One of the main reasons for this kind of thinking is that
people with anxiety disorders have difficulty when they are trying to go to
sleep.

Treatment for these problems involves helping patients recognize how

anxious they are when they try to fall asleep and how they can lower this
anxiety by repeating positive statements that make them want to sleep.

How to treat panic attacks with CBT

Panic attacks are sudden intense fear in response to a nonspecific and
highly personal threat. The attacks may happen without warning. They
might begin with many feelings (e.g., chest pain, chills, numbness), followed
by hyperventilation and a sense of suffocation. It is most common during
physical exertion or roughly an hour before bedtime. Panic attacks are often
experienced in the context of other panic disorders or phobias (such as
obsessive-compulsive disorder). Although panic attacks may occur in
isolation, they can also accompany agoraphobia and social anxiety disorder.

To treat panic attacks, therapists have focused on the cognitive behaviors

that are often associated with the disorder. For example, people with panic
attacks may feel overwhelmed by the presence of others. The therapist, in
this instance, might ask them: "What is your perception of how safe you feel
in social situations?" This is called distancing because the individual feels as
if they are not involved in the situation. Furthermore, they may consider
another person a threat while standing in line at a store and then fear any
small movement or noise. As mentioned above, these thoughts also lead to
hyperventilation; therefore, it is important to help clients recognize how
their fear prevents them from breathing normally and leads to other
physical symptoms (e.g., chest pain, chills, and numbness).

CBT also helps people recognize their feelings of panic. For example: "I am
feeling fear, and I am breathing a lot faster." Furthermore, the therapist can
help clients see the relationship between their feelings of panic and other
life situations by asking them to recall why they have had panic attacks. For
example, suppose a life situation is related to the anticipation of another
anxiety-producing event (e.g., they might have a panic attack before going
on vacation). In that case, they should be asked what would happen if they
did not anticipate that situation anymore. In addition, more specific
questions are often used to teach clients how to treat some of their
symptoms (e.g., "What do you do when your heart races?").

CBT is sometimes used in combination with medications. There is strong

evidence that CBT can help reduce panic attacks and the need for
medication for people with a history of panic attacks (as well as
agoraphobia and social phobia). The addition of CBT has been shown
effective in those who are treatment-resistant to taking medications.

CBT is the most effective treatment for anxiety disorders. There are several
ways it works, and it focuses on understanding why the person has anxiety
disorders, what triggers them, and what makes them continue. Once a
person understands their anxiety and its patterns, they can begin to take
control of their anxiety.

Anxiety is a response to stress and a part of our natural defense system. The
problem comes when the anxiety becomes excessive, occurs at the wrong
time, or happens for no reason. When this happens, it is an anxiety disorder
and can greatly affect one's life. It may be hard to do things that people
usually do not think twice about: going to work or school, cooking, driving,
dating, etc. Some people may also have physical symptoms associated with
their anxiety, such as nausea or dizziness; these are called panic attacks.

How CBT works for obsessive-compulsive disorder (OCD)

Obsessive-compulsive disorder (OCD) is characterized by obsessions
(obsessive thoughts) and compulsions (a compulsion to do something).
Obsessions are thoughts that cannot be controlled and are often perceived
as unacceptable. For example, people with OCD obsess about dirtying or
infecting themselves or a loved one. As a result, they may wash their hands
numerous times or lock the door repeatedly. The compulsions are behaviors
the individual feels compelled to perform in response to the obsession; they
usually bring temporary relief but only last for short periods. Compulsions
include cleaning, counting, checking whether doors are locked, arranging
objects in a certain order, etc.

Obsessive-compulsive disorder (OCD) is a more common disorder than

people realize. It affects approximately 2.5 percent of the population, or 1 in
every 40 people; however, this is often underreported because many
individuals do not seek treatment. Furthermore, OCD is frequently
accompanied by other disorders such as depression, anxiety, and eating
disorders; these disorders are often treated with medication, leading to
drug abuse.

OCD has several characteristics: obsessions (an obsessive thought),

compulsions (a compulsion to do something), and resistance and avoidance
of fearful situations. It is a type of anxiety disorder.

OCD often causes people to be anxious, depressed, and upset. It can also
cause people to avoid things that do not need to be avoided, such as certain
situations or people. People with OCD often have obsessions with
contamination and germs; they may feel compelled to wash their hands
several times throughout the day or avoid touching certain objects because
they think they will get germs on them. Conversely, people with OCD may
have obsessions about the wrong things (e.g., insects, hair) and compulsions
that involve washing or checking those items over an excessive amount of
time. For example, they may feel compelled to check the back of their
eyelids, count certain things (e.g., the items in a drawer), or touch certain
objects multiple times before performing a task (e.g., doors, doorknobs).

OCD is not always the same for everyone, but it can cause severe problems
and may interfere with everyday functioning. People with OCD often do not
want to seek help since they fear their obsessions are wrong; however,
treatment can help relieve the obsessive thoughts and compulsive
behaviors.

Many treatment options are available for people with OCD; however, CBT
reduces symptoms. This therapy aims to help clients identify their negative
beliefs about themselves, others, and situations and to modify those beliefs
so that they are more realistic. In addition, therapists often use exposure
and response prevention to help people overcome the obsessive thoughts
that cause their compulsions. For example, when people worry about
contamination, they may be asked to do a task involving contamination
(e.g., touch paper for five seconds). The person may also be asked to
perform the same task after their compulsive behavior; however, this time,
they are told not to do the compulsive behavior (i.e., touching the paper).
This process helps with desensitization, which helps people become less
anxious about performing their compulsive behavior.

How to treat weight problems with CBT

People with obesity often report a variety of concerns, including fear of
hurting their health, fear of gaining weight, fear of not being able to lose
weight or keep the weight off, feelings of low self-esteem when they are
overweight or obese, and concern about their appearance and how others
will perceive them. Unfortunately, many people experience these types of
worries long before seeking help. This can cause significant energy,
concentration, and engagement problems at work or school. Studies have
shown that CBT combined with medications is an effective obesity
treatment; behavioral therapy (like CBT) and a structured diet plan improve
outcomes.

Combining CBT methods with weight-loss strategies has proven to be

successful. CBT aims to help people understand their eating habits and the
underlying causes of obesity. When people develop an accurate view of the
situation, they are in a much better position to make lasting changes. One
study on obesity treatment showed that about 74 percent of participants
experienced weight loss after undergoing CBT for six months. These results
were similar regardless of age or gender.
This form of treatment is known to help people with eating disorders. CBT
aims to help people understand their eating habits and the underlying
causes of their disordered eating. When people develop an accurate view of
the situation, they are in a much better position to make lasting changes.
For example, one study on CBT for people with bulimia showed that about
56 percent of participants experienced weight loss after undergoing CBT for
six months. These results were similar regardless of age or gender. Overall,
after three months, patients experienced remission from symptoms,
including binge-eating and purging behaviors and psychological symptoms;
however, there were some fluctuations in symptom severity over time
compared to pretreatment levels.

Some weight-loss strategies involve creating a diet plan and increasing

physical activity; however, dieting often does not work in the long term.
CBT focuses on dieting and exercise and overcoming negative weight
thinking. CBT aims to help patients develop healthy eating and exercise
habits. CBT therapists help patients identify and replace negative thoughts
so that it becomes easier to make healthy choices. CBT techniques can be
used in conjunction with any weight-loss method.

People who have undergone a concussion often experience headaches,

dizziness, or problems with memory or concentration; however, these
symptoms usually improve after one year. Unfortunately, many people do
not recover as expected and instead continue to have abnormal brain
activity, depression, and anxiety. In addition, treating concussions with
medication can lead to drug abuse.

People who are overweight or obese should be given personalized treatment

plans by their physicians and therapists. This involves working with people
to find the underlying causes of their weight issues and setting a realistic
goal appropriate for their health concerns, medical history, lifestyle, and
current psychosocial situation. In addition, there should be a focus on self-
awareness, healthy eating habits, and increased physical activity through
exercise.

Weight problems can often be treated with CBT. However, this treatment
cannot always resolve all of the individual's issues. Instead, treatment
involves identifying the distorted thinking patterns causing the problem and
replacing them with more realistic thinking. For example, a person may fear
gaining weight because they believe that food will make them fat despite
their size. Working with the patient to identify this distorted belief can lead
to successful weight management.

Therefore, CBT can be used in conjunction with other types of treatment for
these disorders. This can help people overcome the obsessive thoughts,
feelings, and behaviors associated with their depression and anxiety
disorders.

CBT, including cognitive behavioral therapy (CBT) and behavioral activation

therapy (BAT), can be used to treat OCD. These forms of treatment include
exposure, response prevention (ERP), and cognitive restructuring
techniques. CBT is a form of psychotherapy that focuses on helping clients
identify the negative thoughts and beliefs that cause their obsessions and
compulsions and ways to change those beliefs.

How to treat bipolar disorder with CBT

Cognitive-behavioral therapy (CBT) effectively prevents or mitigates
depression, anxiety, and overall distress in bipolar disorder. It is also used
to help individuals manage their physical symptoms and reduce the number
of relapses. In addition, CBT is often used to treat bipolar depression by
improving sleep quality, reducing fatigue, and helping patients with
problem-solving skills.

CBT is effective partly due to its ability to help patients change their
emotions, thoughts, and behaviors to cope better with stressors in their
lives. Therefore, CBT is regarded as an appropriate treatment for PTSD as it
helps a person cope psychologically with their experience.

CBT is also used to treat trichotillomania (compulsive hair-pulling) and

excoriation disorder (compulsive skin-picking). Treatment for these
disorders can include attention, relaxation, habit reversal, and response
prevention.

Although data on the use of CBT for substance abuse is limited, many
researchers focus on individual CBT for substance use problems. People
with Substance Use Disorders often have impaired decision-making skills,
leading them to make poor choices about their drug use. In addition, people
with addiction often have a poor self-image and feel weak-willed or out of
control. CBT is designed to correct these issues by helping people modify
their decision-making skills, identify negative thinking patterns, and relearn
self-control.

Like substance abuse studies, the data on CBT for gambling addiction is
limited; however, one study found that CBT combined with medications had
a greater positive impact than medication alone or CBT alone. According to
this study, people in the medication-only group were more likely to
experience recurring thoughts of gambling than those in the group
receiving both treatments.

CBT helps treat these disorders by targeting the thoughts and behaviors
causing problems. After identifying the harmful thoughts or behaviors and
replacing them with positive ones, individuals can effectively cope with their
anxiety or depression symptoms. CBT also teaches clients to identify
automatic thoughts or beliefs that trigger anxiety and depression and create
alternate ways to cope with stressors.

In one study, CBT significantly impacted participants' emotional well-being,

self-esteem, behavior, and job satisfaction two years after the treatment
ended. Furthermore, people who completed the treatment were less likely
to relapse into depression than people who did not receive the treatment. In
addition, those who completed CBT reported less severe depression than
people who received no therapy in follow-ups.

Bipolar disorder affects approximately 2.6% of the US population, with a

lifetime prevalence between 5% and 10% in the general population. It is a
severe psychiatric disorder that interferes with an individual's functioning
and quality of life. People diagnosed with bipolar disorder are at risk for
both depressive and manic episodes during which they may experience.
These episodes of depression or mania can last days, weeks, or months.

The symptoms associated with both depressive and manic episodes are
severe and interfere with an individual's ability to work and maintain
relationships. Symptoms of depressive episodes include severe depression,
weight loss, difficulty sleeping, fatigue, feelings of guilt/worthlessness,
suicidal ideation/attempts, decreased concentration, and negative self-
image. In contrast to this, CBT helps people with bipolar disorder by
teaching them to monitor their moods; identify negative thinking; express
emotions appropriately; problem-solve and make decisions; solve
interpersonal problems; build on personal strengths; control over-thinking
and avoidance behaviors; develop regular patterns for sleeping, eating,
working and recreation activities.

In addition to the symptoms of depression, manic episodes are marked by

feelings of euphoria and elevated mood, talking very rapidly and jumping
from one idea to the next, increased activity; decreased need for sleep,
racing thoughts; difficulty concentrating; grandiose beliefs/self-importance;
impulsive behavior; sexual disinhibition.

How to eliminate procrastination with CBT

Cognitive-behavioral therapy (CBT) has been proven effective in treating
severe procrastination by targeting the condition's cognitive, emotional, and
behavioral symptoms. This therapy focuses on changing a person's
automatic thoughts, irrational beliefs, and maladaptive behaviors that
interfere with addressing important tasks.

CBT helps people with OCD identify their obsessions and how they relate to
their compulsions. It then helps them develop coping skills by exploring the
situations in which these thoughts occur and learning how to change their
behaviors when they have an obsession. For example, one study focusing on
people with OCD found that CBT reduced worry about negative events,
improved mood, and increased overall satisfaction with life compared to a
control group. The study also found that people in the CBT group were less
likely to feel "stuck" or unable to control their symptoms and more likely to
seek treatment after completing CBT.

CBT targets social, behavioral, and cognitive aspects of tics. It focuses on

helping patients identify the thoughts and behaviors causing their tics and
replace them with less disruptive ones. It also encourages patients to
challenge irrational beliefs contributing to their tic symptoms.

CBT, especially in combination with other types of therapy, is an effective

treatment for bulimia nervosa. CBT helps reduce binge eating and negative
body image associated with this disorder. The treatment also helps patients
identify irrational beliefs and worries about the weight that often contribute
to binging episodes. In addition, it teaches them coping skills that enable
them to eat more in moderation.

CBT can treat generalized anxiety disorder (GAD). Although the

mechanisms by which it works are unknown, CBT effectively reduces
anxiety symptoms and improves overall functioning. In addition, clinical
trials have shown the benefit of CBT over medications when GAD is not
severe enough to warrant medications.

Procrastination is a common problem that occurs in people of all ages. CBT

is a psychological treatment designed to help people focus their efforts
more efficiently and reduce procrastinating time. CBT teaches people how
to break down large tasks into smaller ones and allocate their limited time
to complete them promptly. This allows people to get more done in a
shorter amount of time.

Some CBT techniques, such as rolling a ball back and forth between hands,
or twirling a pen, can also help people with ADHD control their attention
span. These techniques increase focus and reduce restlessness.

Cognitive-behavioral therapy is effective in treating ADHD. The treatment

has been applied to children and adults with the disorder; it improves
symptoms by teaching people how to monitor their symptoms and change
unhelpful thoughts and behaviors that may be contributing to their ADHD.

Therefore, procrastination can be a major problem for people of all ages. It

can seriously affect productivity and quality of life, making it very important
to address it appropriately. CBT can help people suffering from
procrastination to get more done in less time, improving their productivity
and overall quality of life. CBT techniques, such as rolling a ball back and
forth between hands or twirling a pen, can also help people with ADHD
control their attention span to focus on the tasks at hand. In addition, better
attention spans coupled with the flexibility to shift tasks keep work from
becoming stale and make it more enjoyable for employees.

How to treat PTSD (post-traumatic stress disorder with CBT)

Cognitive-behavioral therapy (CBT) is effective for PTSD, especially when
combined with exposure therapy, which can help people overcome their
fear and re-inoculation to situations that cause anxiety. Exposure therapy is
a CBT technique that involves confronting one's fear of being outside the
safety of their home, like attending social events or playing games with
children. Plus establishing new and more productive behaviors like
initiating conversations and volunteering to help. CBT is also used to
improve symptoms of OCD; this treatment has been proven effective in
treating various disorders, including depression and phobias.

PTSD was first described in 1980 by psychiatrists and psychologists. It is an

anxiety disorder caused by a terrifying event that overwhelms the person
experiencing it. The person may not have been physically harmed during
the event, but they believe they are in danger. This can lead to feeling
emotionally numb, suicidal thoughts, nightmares, and flashbacks of the
event.

CBT is a form of psychotherapy that anyone with PTSD can use to help them
feel better and manage symptoms like anxiety or depression that may be
related to their traumatic experience. CBT focuses on four components of
treatment for PTSD: emotional regulation, maintaining healthy relationships
and lifestyle, and learning new ways to cope with feelings.

Treating PTSD involves reducing or eliminating the anxiety caused by the

traumatic event and helping the person cope with the symptoms. The goal
of cognitive therapy is to help patients analyze their thoughts and change
them in a way that helps them feel better about themselves and their ability
to cope. Over time, this helps reduce triggers for anxiety or flashbacks
related to the trauma, teaches people how to manage daily stressors, and
gives them tools for managing emotions. Moreover, it improves their ability
to have healthy relationships and helps them develop confidence in their
abilities.

Therefore, PTSD is an anxiety disorder caused by a terrifying event that

overwhelms the person experiencing it. The patient may not have been
physically harmed during the event, but they believe they are in danger.
This can lead to feeling emotionally numb, suicidal thoughts, nightmares,
and flashbacks of the event. The goal of cognitive therapy is to help patients
analyze their thoughts and change them in a way that helps them feel better
about themselves and their ability to cope. CBT reduces or eliminates the
anxiety caused by the traumatic event and helps patients with PTSD cope
with their symptoms over time. In addition, it improves their ability to have
healthy relationships and helps them develop confidence in their abilities.

How to use CBT to overcome Negative Automatic Thoughts

(NATs)
NATs are common in people with depression. They are the unproductive (or
negative) thoughts that people with depression habitually tell themselves,
such as “I’m a loser” or “I can’t do anything right.” They can also include
thoughts like “I am worthless,” “everything is bad,” or “I will never achieve
anything in life.” Cognitive-behavioral therapy (CBT) is a type of
psychotherapy used to treat depression. The therapy involves changing
unhelpful thoughts and behaviors to improve mood and overall quality of
life. CBT helps people reframe their negative self-evaluations and harsh
criticism of themselves to more positive ones. Furthermore, CBT can help
people think about issues in new ways, and this can help them cope with
stress and negative thoughts about themselves or the world.

Many people try to ignore NATs or even pretend they don’t have them;
however, this usually makes things worse because the problems continue to
pile up without getting resolved. However, CBT offers a way to identify
NATs and work on them to address issues and improve mood. CBT aims not
only to change negative thoughts but also to change behavior patterns and
overall outlook positively. Through CBT, people can learn what causes
distortions or errors in thinking or behavior and the skills necessary for
changing those thoughts and behaviors.

CBT helps people with depression identify the things that are causing stress
in their lives. In addition, because depression is related to cognitive
processes, including unhelpful thinking, CBT can help people with
depression overcome their difficulties by changing how they think about
themselves, other people, and situations. CBT also helps them develop
strategies and coping skills to make them feel better in all relationships.
Anxiety Disorders are the most common mental disorders in the United
States. Panic attacks, phobias, and generalized anxiety disorder are specific
types of anxiety that have distinct symptoms among similar disorders. The
center of treatment for these disorders is cognitive-behavioral therapy
(CBT). CBT is a type of psychotherapy that can also be used to treat
depression and substance use disorders. It involves helping people learn to
identify negative feelings and thoughts while experiencing them to
understand what triggers those feelings, prevent them from happening
again, or change them when they occur. In addition, CBT helps people keep
track of their symptoms and triggers for anxiety.

NATs are common in people with depression. They are the unproductive (or
negative) thoughts that people with depression habitually tell themselves,
such as “I’m a loser” or “I can’t do anything right.” They can also include
thoughts like “I am worthless,” “everything is bad,” or “I will never achieve
anything in life.” Cognitive-behavioral therapy (CBT) is a type of
psychotherapy used to treat depression. The therapy involves changing
unhelpful thoughts and behaviors to improve mood and overall quality of
life. CBT helps people reframe their negative self-evaluations and harsh
criticism of themselves to more positive ones. Furthermore, CBT can help
people think about issues in new ways, and this can help them cope with
stress and negative thoughts about themselves or the world. Therefore, CBT
is an effective treatment for anxiety disorders because it focuses on helping
people learn to identify and deal with their fears and reduce the severity of
their symptoms.

Cognitive-behavioral therapy (CBT) is a type of psychotherapy used to treat

depression. The therapy involves changing unhelpful thoughts and
behaviors to improve mood and overall quality of life. For example, CBT
helps people reframe their negative self-evaluations and harsh criticism of
themselves to more positive ones. Furthermore, CBT can help people think
about issues in new ways, and this can help them cope with stress and
negative thoughts about themselves or the world.

How to use CBT to solve common thinking errors

Various types of CBT are available for people with depression. The most
commonly used type involves working on unhelpful thinking and problem-
solving techniques. CBT works best when it helps people evaluate the
situation, decide what to do, make a plan, and then implement their plan. It
also helps people deal with difficult situations by modifying or changing
their responses. These situations include dealing with anxiety issues,
anxiety triggers, self-defeating thoughts or behaviors (such as smoking),
and depressing emotions that lead to low moods. CBT helps people develop
skills in working with stressful situations and their emotions, reduce stress,
and become more effective at coping with the problems that make them feel
less overwhelmed.

Thinking errors are the common, unhelpful ways of thinking or problem-

solving that people with depression often use. These errors include negative
self-talk, unrealistic expectations, negative reactions to stressful events, and
mind reading. Using CBT, people with depression can learn and practice
problem-solving skills, manage their distress after a stressful event, reduce
their negative thinking patterns, increase the positive aspects of their
moods (affect regulation), and help them be more effective at problem-
solving. The cognitive part of CBT focuses on helping people identify
treatment goals and determine what they need to do to achieve those goals
to feel better. To determine treatment goals, people being treated with CBT
must first identify problems causing stress in their lives. As part of this task,
people should create a list of events that may have caused depression or
other feelings, such as anger or sadness. The cognitive part of CBT is one
way to accomplish this goal because it helps people identify their thinking
errors and learn coping skills to deal with them. The behavioral aspect of
CBT involves learning and practicing problem-solving techniques, which is
another way for people with depression to improve their moods and manage
stress.

CBT is a type of psychotherapy used in the treatment of depression. It can

be considered a form of psychotherapy that encourages people to change
their thinking patterns, habits, and ways of acting to bring about significant
changes in mood and behavior. The cognitive aspect of CBT focuses on
changing unhelpful thinking patterns causing symptoms. These include
thinking habits linked to depression, such as negative self-talk and distorted
reasoning. The behavioral aspect of CBT is a way for people to develop
skills to cope with problems and distress after stressful events. For
example, this part of the treatment could involve learning how to begin
problem-solving techniques, such as breathing to reduce anxiety, focusing
on the positive aspects of life and helping other people, or reducing the
effort to complete tasks. The behavioral aspect of CBT is also used to help
people learn healthy and adaptive ways of coping with their distress, such
as exercising to reduce stress or setting goals for stressful events.

CBT aims at changing distorted thinking; it encourages individuals to

identify specific irrational thoughts causing negative moods and to begin
changing these thoughts into more realistic ones. By identifying irrational
thinking, cognitive distortions will be reduced, and one’s mood will improve.
According to the theory, the mood will improve if irrational thinking is
reduced. However, CBT does not promote the idea of changing one’s
personality characteristics or behavior.

Cognitive-behavioral therapy (CBT) aims at changing distorted thinking and

incorrect beliefs to reduce depressive symptoms. CBT attempts to identify
erroneous, dysfunctional thought patterns that lead to negative moods and
problematic behaviors to modify these thought patterns through cognitive
restructuring in an attempt to alter behavior and manage negative
thoughts. Cognitive restructuring has been observed as a therapeutic
technique in treating depression, which involves the modification of
cognition causing depressive symptoms. This process alters information
processing to improve distorted cognitions and beliefs.

CBT aims to help people modify dysfunctional thought patterns to reduce

depressive symptoms. According to the theory, a dysfunctional thought
pattern can result from a person’s belief system. A person's beliefs are their
way of perceiving, interpreting, explaining, and understanding their
experiences; they are the basis of their thinking and behavior. Depressive
thinking is usually based on the idea that something negative has happened
or will happen. As a result, people tend to focus on these negative thoughts,
which cause negative feelings and behaviors, resulting in a downward spiral
toward depression. In cognitive therapy, people struggling with depression
learn more appropriate ways of viewing situations, thus reducing depressive
symptoms.

A solution to common thinking errors for depression is to challenge beliefs

and assumptions by questioning and testing them instead of accepting
them. By challenging these irrational, negative thoughts, new perceptions
of the situations will be formed. These new perceptions can alter a person's
mood or behavior. This is one way CBT attempts to help someone who has
depression by challenging their irrational beliefs. For example, if an
individual were to abandon the belief that they were less capable than
others because they had not achieved as much in their life as others, this
would result in increased self-esteem and a positive change in mood. By
changing the thought process that leads to a depressive mood, one can
improve their symptoms and reduce the severity of their condition.

Cognitive-behavioral therapy is based on the fact that negative symptoms of

depression are learned and can thus be unlearned. Based on this theory,
depressive symptoms can be improved by addressing their behavioral
manifestations. CBT, then, is a process of learning about the way one thinks
and learns to correct these negative thoughts that may result in depression.
In this regard, cognitive-behavioral therapy can be seen as helping an
individual understand how they think. If an individual already understands
their thought process, they will have no problem correcting them if they
become distorted or irrational.

How to treat infertility with CBT

This is a new approach to treating infertility. Infertility is a condition that
affects about 6 of every 1000 couples. The most common reason for
infertility is low sperm count or poor quality of sperm. This condition can
also be caused by impotence, blocked fallopian tubes, and tubal blockage
due to previous surgeries or infections. Some drugs and substances are also
associated with the lack of fertility in men. Infertility can be difficult to treat
as it is not always easy to identify the cause (low sperm count, poor quality
of sperm, blocked system), and there is no reliable way to predict how long
an individual will have bad results from treatment. One common treatment
is Clomid which can result in multiple pregnancies after one cycle of
treatment if used incorrectly with short-term alternate options available.
The other methods include donor eggs (available in some countries) and
long-term use of Clomid, IUI, and IVF.

Pregnancy is an important event in a woman's life, and her mental state

should be considered during the entire process, from pregnancy to
childbirth. Depression during pregnancy does not lead to childbirth
complications but can affect the mother's mood and behavior. As there are
many possible causes of depression that a woman may encounter during
pregnancy, it is important to identify the cause of the problem before
deciding on treatment options.

Clinical psychologists also have an important role in treating women who

are suffering from depression while they are pregnant or when they are
preparing to conceive. Some psychologists also use cognitive-behavioral
therapy to treat women experiencing depression, especially during the
perinatal period (during pregnancy). According to some specialists,
cognitive-behavioral therapy is useful in "teaching women how to identify
and reduce stress as well as managing their emotions and helping them to
develop a healthy self-image."

When a doctor or psychologist diagnoses his patients with depression, he

will recommend a specific treatment for each individual. For example, some
may need anti-depressants while others just need simple psychotherapy. In
addition, cognitive behavioral therapy treats people with depression
because it focuses on improving self-esteem.

Therefore, CBT helps in the treatment of infertility in the following ways:

- Self-esteem improvement: CBT is used to help women gain self-confidence

through various techniques such as relaxation training and positive self-
talk. This way, a woman can deal with the stress of infertility and protect
her emotional well-being.

- Stress regulation: Cognitive behavioral therapy can be used to stress

regulation as it provides the tools for women to identify, evaluate, and
change their thoughts that contribute to their anxieties. For example, CBT
teaches women how to manage negative thoughts when undergoing
infertility treatments, recognize anxiety symptoms, and then manage those
symptoms to relax and reduce stress.

- Stomach ache and anxiety: Cognitive behavioral therapy teaches women

how to recognize and deal with their symptoms of stress and anxiety. For
instance, they can learn to identify their symptoms by asking themselves
what they are feeling (anxiety, stress, or tension) and when did they feel
this way (how long before the menstrual period), then learn different ways
to relax or manage these symptoms without having negative effects on their
mental health.

- Emotion regulation skills: Cognitive behavioral therapy teaches women to

identify negative emotions such as anxiety, depression, or anger. This way,
women can learn how to cope with these emotions when needed healthily
by understanding them so that they will not lead to other harmful
consequences such as drug abuse or suicidal thoughts.

- Coping skills: Emotion regulation is a coping skill used to help women

cope with their stress and anxiety levels. Women can learn to solve healthily
instead of being passive and then becoming aggressive, which usually leads
to depression.

- Stress inoculation training: cognitive behavioral therapy can be used to

reduce stress by teaching women how to adapt to and change adverse
situations through various techniques such as realistic thinking, mental
distraction, relaxation, increasing mastery, and catalytic thinking. The
purpose of this technique is for women to recognize when they are feeling
stressed, anxious or angry so that they can healthily manage these
symptoms.

CBT and NLP for treating depression and anxious thinking

Sometimes this condition has been linked to the doctor's ethical pre-set
choices that minimize risks for the patient in their treatment plan. However,
when it comes to CBT and NLP, there seems to be a consensus that maybe
these techniques can provide patients with a more effective solution when it
comes to anxiety and depression by giving them tools at their disposal they
never had before. Despite this, there is still much research and controversy
surrounding these two psychological approaches to topics such as mental
health issues.

CBT and NLP continue controversial because some people do not want to be
treated with these techniques. This is a cause for concern because an
individual that does not want to be treated with CBT or NLP will most likely
default to medication and may be at risk for poor outcomes. Therefore, the
conversation surrounding CBT and NLP must become more open and
honest, especially when dealing with those experiencing anxiety or
depression.

The greatest concern concerning CBT and NLP is that patients without
depression but with anxiety can experience something referred to as
"reactive depression." This form of depression is related in many ways to
OCD, where the thought process is known as Ruminations or Rumination.
The difference between the two is that they are moods. The thought process
of Ruminations is often what goes on unconsciously, and if it's not
addressed in time can lead to the development of depression. The term
"reactive depression" is often defined as the depressive type that happens in
response to a stressful life experience, such as losing a job, being criticized
at work, experiencing family problems, or having to move. The good news is
that CBT and NLP are among the most effective treatments for anxiety and
depression because they can help patients confront and deal with these
issues head-on.

A couple of different aspects regarding CBT and NLP effects on these

disorders must be mentioned. For example, research shows that effective
counseling interventions are one of the best ways to treat anxiety or
depression and provide patients with a better quality of life. CBT and NLP
are both effective in treating depression and anxiety. The one thing
researchers must consider when dealing with CBT and NLP is that some
patients may be more prone to these techniques than others, especially if
they have a family history of mental health problems. The important thing to
remember is that not every patient will respond to the same treatment. Still,
finding what works for the individual will ultimately aid in improving their
recovery.
Some patients may not respond well to traditional CBT and NLP because it
does not meet their needs or because unique features are associated with
their disorder. The good news is that researchers are studying other
counseling interventions that may be more effective in treating anxiety or
depression. Research on other treatments must continue, but so far, they
are not as effective as CBT and NLP.

When it comes to effectiveness, there is solid evidence that CBT and NLP
are effective when treating depression and anxiety. In one study, however,
only 9 percent of patients improved with these therapies alone; in
comparison, 50 percent improved with the addition of medications. The
research must continue to be performed, but so far, it has shown that the
combination of counseling and medication is the most successful method.

In many ways, CBT and NLP are two different techniques that can be used
alongside each other to produce more effective results for anxious or
depressed individuals. For example, CBT and NLP can be used
simultaneously to help patients that have not responded well to either CBT
or NLP because it gives them other options that were never there before.
These two techniques will continue to be researched, but the consensus is
that they offer an effective way of treating depression and anxiety.

Cognitive behavioral therapy and neurolinguistic programming can be used

to treat anxiety.

The combined use of CBT and NLP will continue to improve since both
techniques are effective for individuals that experience anxiety and
depression. CBT alone may not be the most effective practice for treating
this illness, but it is worth the effort because it can help people deal with
these conditions and improve their quality of life. Therefore, using both CBT
and NLP is something individuals should consider, especially if it has not
helped them much.

A multi-modality treatment approach must be employed when treating

anxiety or depression. With CBT, patients are often given homework or self-
reflection exercises to continue treatment. For example, if a patient is
experiencing anxiety, they may be asked to write down all the things they
worry about and how they think these thoughts will play out. A patient may
also be asked to identify times in the past when anxiety was present and
what actions they took at that time. Likewise, when dealing with
depression, patients may be asked to think about situations where they feel
depressed and talk about this experience internally.

Another thing to consider is that there can be a lot of confusion in many

cultures concerning CBT and NLP. Therefore, patients must be educated
before they enter therapy or counseling concerning their diagnoses and
how they will be treated during their sessions or sessions. There is a
difference between psychotherapy and counseling, but when it comes to the
latter, the patient's injuries should not be exposed, as this may lead to
dismissal from treatment.

There are some other aspects to these approaches that may need more
attention when it comes to the treatment of anxiety disorders.

Another example that causes people to become overwhelmed with anxiety is

when a person experiences something known as "chronic worry." This is
when one repeatedly thinks about a topic for days or weeks. It can be about
finances, relationships, personal problems, or anything else that might need
to be attended to in the future. This concept has similarities with OCD and
is associated with the thought process known as Obsessive Compulsive
Disorder OCD.

According to the book, "... the fact that there are still some persistent
controversies about certain topics related to CBT and NLP has been a
source of irritation for many researchers, who feel that instead of sticking
to one specific approach to treatment, they should be able to draw from
more than one theory when they start their sessions with patients. The idea
is to avoid creating thought patterns in their minds that are rigid and
inflexible, which is what seems to occur in people with anxiety disorder or
depression.

The next chapter will discuss Dialectical Behavior Therapy (DBT). This
therapy is based on the Cognitive Behavioral Theory. The theoretical
concept behind DBT is that the therapist should focus on the patient's
trauma history rather than symptoms. Rather than trying to eliminate these
painful memories, DBT focuses on accepting and containing them so that
they become manageable and less stressful. In addition to helping
individuals increase their mental health and break free of destructive
thought patterns, DBT is also focused on teaching individuals how to reduce
their impulsivity, manage their emotions effectively, and improve
relationships.

DBT includes several components, including relapse prevention skills

training, acceptance skills training, mindfulness components, interpersonal
effectiveness training, and safety planning. In addition, DBT aims to teach
individuals how to reduce their self-destructive behaviors and increase their
capacity for functioning.

Dialectical Behavior Therapy is based on multiple concepts used to treat

Borderline Personality Disorder, Bipolar Disorder, and other mental health
issues. This therapy teaches individuals how to manage their emotions
effectively and improve relationships.
Chapter 2. DIALECTICAL BEHAVIOR THERAPY
 What is DBT?
Dialectical Behavior Therapy (DBT) is a treatment for Borderline Personality
Disorder, which is characterized by emotions including anger, feelings of
inadequacy or emptiness, difficulty controlling anger, and self-harm. DBT
seeks to reduce these symptoms by using different therapeutic techniques,
such as mindfulness skills and dialectics. Dialectical therapy can be
particularly helpful for people who experience mental health problems that
cause feelings of worthlessness. Dialectical therapy is effective because it
gives people a sense of meaning in their treatment and control over their
environment. People who experience Borderline Personality Disorder
typically have trouble controlling their emotions due to how they perceive
things. The way that they perceive "self" is often negative and always
consuming, and they cannot accept parts of themselves that they do not
like. In addition, these individuals frequently feel isolated when trying to
understand their emotions or other people's emotions. Dialectical therapy
can help individuals manage all these feelings by using dialectics as
communication. People experiencing Borderline Personality Disorder often
have difficulty understanding the need to expose and accept their failures.
Still, dialectics are a way for them to understand that failing is an important
part of life. Dialectical therapy is a helpful form of communication that
emphasizes respecting and acknowledging others in the process of
remembering to do so. DBT does not focus on symptom elimination but
prioritizes effective risk management and core mental health improvement.

Dialectics can be defined as a method of solving problems involving

contradictions or mutually exclusive positions. If two positions cannot be
resolved logically or rationally, dialectics would help unite the two views
into one unified perspective. This unified perspective is a process that helps
individuals from any sort of conflict and problem resolution. Dialectics gives
people a sense of meaning in the treatment and allows them to accept
themselves. In other words, dialectics helps people feel better about
themselves through understanding others' views and perspectives. This
acceptance includes accepting failures because failure can be understood in
relation to the context of one's life for failure to be meaningful. Failure is
often understood as a way for people to grow, and dialectics allows them to
recognize this reality by understanding what it means for those involved
that something was wrong.

Dialectical behavior therapy applies this concept of dialectics to help people

with Borderline Personality Disorder, characterized by experiencing
problems with relationships and emotional dysregulation. People who
experience Borderline Personality Disorder often have trouble
understanding how their emotions affect them and difficulty being involved
in relationships. Dialectical behavior therapy can also help people deal with
strong emotions, particularly anger, and it can help them learn to avoid
situations that are likely to cause problems. By teaching these skills through
methods such as individual therapy, group classes on dialectics, and
exercise groups, people can learn how to cope with their emotions
effectively.

To understand how dialectics works in the subject of DBT, it is necessary to

understand the way that DBT uses a system of four roles: the patient, who
talks about how his or her problems began and are being treated; the
therapist, who provides feedback and holds people accountable for their
actions and behaviors; the therapist, who provides help regarding the
patient's progress; and the therapist, who has a sense of meaning regarding
treatment. As part of this system, therapists must be present throughout
every session to provide useful feedback to patients.

Dialectics allows people recovering from conflict to have a sense of meaning

and control over what happens during treatment. Dialectical Behavior
Therapy can be particularly helpful for people who experience Borderline
Personality Disorder because it allows people to understand the perspective
of others, which helps them understand their own feelings. Dialectical
behavior therapy recognizes the need for failure for anyone to grow and feel
healthy. Dialectics are a powerful way for people to communicate
effectively. DBT can be a highly effective treatment that allows people who
experience Borderline Personality Disorder to have a sense of meaning in
their lives and control over what happens during treatment.

In the past, dialectics was applied in a rigid form of analytical psychology.

For instance, the general perspective on personality was of "the norm," who
had no problems; it was all about getting rid of these abnormalities, which
were believed to be caused by lack of nourishment, i.e., undernourishment.
This kind of thinking made sense because many patients abused day-patient
psychiatrists and other psychotherapists because they presented them with
this rigid picture and expectations that seemed impossible to meet.

The role model that changed everything in this regard was Viktor Frankl.
Frankl offered an alternative to the classical model of psychoanalytically-
oriented psychotherapy known as "analysis", "psychotherapies," and
"counseling" that focused on analyzing symptoms and then treating them.

In a way, Frankl was followed by some other great examples like Carl
Rogers, Jean Piaget, and Erik Erikson. They were also all psychiatrists that
applied dialectics in their specific therapy approaches. On the contrary,
Theodor Reik devoted his life to developing dialectical psychotherapy. He
spent time immersing himself in philosophy and created a comprehensive
theoretical framework of his own concerning learning and experience.

Dialectics is based on the principle of "contradiction," a concept that

describes how success and failure are interrelated. Frankl called his
dialectical approach "process psychology". He studied the meanings and
purposes of human life and looked at the experience of those with different
types of problems. During his research, he noticed that people's reactions to
certain situations were very similar. He found that these reactions came
from a single common source in response to basic needs such as food, fear,
pain, love, and sexuality. His theory explains that everything works
according to social laws: contradictions do not exist due to personal
circumstances; rather, they originate from universal law.

During Frankl's time in the concentration camp, he became acquainted with

"alienation," which is a state of mind that happens when a person is
disconnected from reality and self-identity. Instead, he came to believe that
the following actions accomplished the destruction of an authentic life:

Frankl believed that the experience of personal responsibility was critical to

overcoming his imprisonment. He reasoned that if humanity was to survive
and prosper in this new world order, they must break free from the power
of destruction by focusing on their ability to change situations in their lives
and visioning themselves as able to take action.
Through his research and studies, Frankl developed a system that was a
natural reaction to the contradiction of suffering and survival. This system
focuses on how people react and how to resolve their conflicts. He believed
there were two stages: the stage where individuals are treated as objects
and the stage where they receive care as people.

Frankl believed that psychology should be viewed like an emergency room

in a hospital. The patient has already suffered horribly, and now he needs
assistance to survive psychologically. In this sense, psychologists need to
not only treat the symptoms; rather, they have to use the same type of
measures that are used in emergency medicine to restore normal brain
function. So, in this respect, the priority is not to treat symptoms but to
treat the "whole" person.

Frankl also realized that people have different reactions in their learning
processes. When a human has a goal and finds something that contradicts
his values, he will either search for compromise or change the goal to fit his
values. But if he realizes something is an irreconcilable contradiction that
he can't change or compromise on, he will resort to developing another
value system. This new value system allows him to stand up when others
would lie down and give up. He called this process "dialectics." Simply put,
it describes how people deal with the process of change.

The following example demonstrates this concept:

For a person to improve his life and overcome a situation, he will have to go
through four phases in his life:

These four phases are associated with eight basic values developed during
childhood. By developing strong values, a person can find and express
himself in the world; this is critical for a normal human existence and very
important in improving one's quality of life.

Frankl's DBT, or Dialectical Behavior Therapy, is based on these concepts of

change and values. The main idea behind DBT is that people with BPD have
an intense need to control their lives. This is because they experience a
sense of powerlessness in situations that would normally be experienced as
positive experiences, such as: falling in love and marriage, ordinary jobs
and responsibilities, and having children. On the other hand, people who
have BPD suffer from intense anger and self-destructive behaviors.

These individuals tend to engage in self-destructive behaviors such as

promiscuous sex with many partners or drug abuse. When a situation gets
too intense for them, they tend to have suicidal thoughts and act on them.
The main idea of DBT was to teach these patients how to deal with the
world differently.

Therefore, DBT originated from the basic principles of Frankl's philosophy.

The "values" that people respond to tend to be very simple:

People with BPD cannot learn from experience; therefore, they need the
training to change their thinking and behavior. These individuals are usually
very weak in self-management skills and find themselves wanting, especially
when they have contact with people who can help them. This is why DBT
tones down their emotions. It helps them learn how to cope with situations
better by learning skill sets like impulse regulation, mindfulness, emotion
regulation, and relapse prevention.

DBT has been proven to be effective for BPD patients. Its main purpose is to
help improve the patient's quality of life and decrease self-destructive
behaviors. It is also used as a preventative strategy as it aims to stop the
patient from relapsing and allows him to be in control of his situation.

Despite being based on very different theories and clinical practices, both
theorists agree that they must consider their clients' problems holistically.
The main therapeutic approaches of both theorists center around
encouraging their clients to integrate and accept themselves while
practicing acceptance towards others, emphasizing the importance of
personal responsibility, and teaching them how to take action effectively.

Frankl's chief influence on the current dialectical behavior therapy training

is that there is a dualism at the very core of his theory. He believed there
must be two aspects, "self" and "other," as separate and distinct entities but
interdependent and mutually conditioning one another. This is not just for
theoretical problems in psychology but also practical reasons. Because we
all experience conflict from time to time, it makes sense to split the matrix
of meaning into two parts: one part mediating the other. One of the ways he
understands this is in terms of self-other and task-object distinctions,
namely, that both are self functions that are required for survival (i.e., self-
other differentiation).

This is a way of seeing the world that is very different from the classical
one. He introduces this metaphysical issue by saying that we "must choose
between competing values and [then] choose one." This dichotomy formula
has three main components:

The basic concepts behind DBT are: "acceptance," "dialogue," "change," and
"variability. "Dialogue" is tool therapists use to promote insight into reality
in their clients. The most important characteristic of this dialogue is that it
has to be non-judgmental. This means it should not have an objective tone;
instead, the therapist should have a friendly presence that does not reject
the client's behavior. The three main principles of being non-judgmental
are:

By being more accepting of their actions and thoughts, clients can begin to
accept themselves as they are and learn how to modify their behavior
accordingly, for example learning to accept their emotions at certain times,
such as when they experience low self-esteem or when they are feeling
suicidal. The DBT focuses heal not only the client but also their families and
friends. The focus of this therapy is to help their clients find their true self-
esteem. At the same time, therapists should be prepared to help them
change themselves and how they behave or think; they need to be
intrinsically motivated to do these things.

One of the most important aspects of helping someone modify behavior is

focusing on what they can do instead of what they cannot do. Therapists
must understand that it's not always a matter of what can and cannot be
done.

What are the components of DBT?

The goals of DBT are to help patients find their true self-esteem, change
how they think about themselves and other people, and teach them how to
cooperate with others. DBT uses tools such as differentiating self from
others, acceptance, mindfulness, and relationship skills. It can be described
by three main concepts: meditation, psychotherapy, and community
involvement.

Today some dialectical behavior therapists use a combination of both

therapies like DBT/CBT (as introduced in the book "Dialectical Behavior
Therapy" ).

Psychoanalysis is one of the most controversial therapies out there because

it creates a great deal of confusion about how it functions. It originated
from the idea that our mental life is a continuous system of conflicts, for
example, how we wish to master anxiety but not lose ourselves in an
attempt to do so. This occurs where we are constantly engaged in a never-
ending cycle of trial-and-error and constant adjustment. One major problem
with psychoanalysis is that it assumes people can find the solution to their
problems by looking inside themselves and talking to their therapists
without any input from others (e.g., friends and family).

This therapy is based on the idea that all behavior can be explained by its
hidden meaning, "the unconscious. " Unconscious thoughts are "anxiety-
laden memories, wishes and impulses." Freud said: "In the unconscious,
every motive finds its efficient force, every instinct its appropriate object
and goal."

An unconscious mind is made up of three components: id (unpleasure

reduction or basic instincts), ego (reality testing or method of regular
behaviors), and superego (moral standards). The id works on the pleasure
principle; it always wants what it wants when it wants it. However, if we
don't get what we want when we want it, we go into a state of emotional
turmoil. The ego tries to control these urges by coming up with
rationalizations for why these urges are inappropriate. The superego is the
conscience, whose function is to help us make moral judgments that hold us
accountable for our actions. However, the superego also believes that we
are not bad beings and want to care for others.

In "The Ego and the Id," Freud describes a theory of sexual development
wherein infantile sexuality is set in motion as an act of aggression. The
egotistical (ego) process represents adult sexuality coming into conflict with
itself, resulting in motor disturbances because each part of one's
personality is trying to express itself simultaneously. These conflicts are
resolved through such methods of "defusion" as dreaming. The fantasy
enables one to see the conflict without the discomfort or guilt that might
otherwise be associated with it.

a. Meditation

As a DBT concept, meditation is a form of self-treatment that allows the

client to relax and focus on reducing anxiety. The meditation process is
particularly helpful because it enables clients to develop "non-attached
awareness." This means they are aware of the here and now without being
attached to the past or future. Clients learn these skills by "recognizing
their thoughts, focusing on their breathing, and turning away from their
emotions." Meditation also helps clients understand how to respond
differently to stressful situations when practicing this skill.

b. Psychotherapy

Psychotherapy takes a variety of forms, such as individual therapy, group

therapy, family therapy, time-limited therapy, and long-term therapies. DBT
approaches therapy as a prevention and healing process by addressing the
client's current problems. Individual therapy is particularly helpful because
it helps clients learn how to deal with painful emotions with skill. The
program may also suggest that clients seek psychotherapy from a therapist
outside the DBT program.

c. Community Involvement

DBT clients are encouraged to participate in a program called "community

involvement." This process encourages them to get involved in the
community by volunteering, working, going to school, etc. It is believed that
being involved in the community will help them learn how to relate better to
the world at large, which will enable them to make friends and grow as
individuals.

Doing something different requires commitment and a willingness to try

new things. As an approach, DBT is not easy. It is complex because it
encompasses many treatment techniques and relies on collaboration
between patients and therapists. It is also a very time-consuming treatment
because its goal is to change clients' whole way of thinking, which can take
years. Finally, DBT can be costly for patients and families. Unfortunately,
most insurance companies do not cover treatment using this therapy, so
many people cannot afford it.

DBT effectively reduces self-destructive behaviors and increases adaptive

behaviors in people with BPD. DBT does not work for everyone, but it can
help those for whom other treatments have failed. It appears to work
particularly well when patients are highly motivated because they are
committed to completing the treatment. It can be a very scary process for
the patient, but they should try to take it one day at a time.

Therefore, DBT components include:

a. Medication and Case Management

Medications are used to control symptoms of BPD. The most frequently

prescribed medication for BPD patients is a mood stabilizer/anticonvulsant
called lithium. Key to the management of this condition is early intervention
before medication side effects have time to develop into a full-blown episode
that may require inpatient treatment. The third element of the DBT
program is case management, which streamlines and coordinates the
multiple services needed by patients with BPD who are eligible for
treatment under Medicaid.

b. Education, Therapy, and Psychoeducation

Psychoeducation is a major component of DBT; it includes reading self-help

books and attending group and individual therapy. One of the main reasons
that people with BPD engage in self-injury is to avoid their intense
emotions. The "emotional regulation" (ER) skills teach patients how to cope
with feelings without resorting to self-injury. During treatment, patients are
taught four skill modules: mindfulness (reduces suffering by staying in the
present); interpersonal effectiveness (helps patients communicate
assertively without anger); emotion regulation (helps patients manage
intense emotions without acting on them); and distress tolerance (teaches
people how to be comfortable when they feel unhappy). It is believed that
these skills change the brain.
c. Family and Community Involvement

DBT therapists actively encourage family members and other important

people in the individuals' lives to get involved in the treatment. This may be
as simple as encouraging their attendance at group sessions if they are not
already involved. It is also helpful to work with family members to learn
how to help the person with BPD. DBT therapists often ask about the
individual's relationships, such as how the individual feels about his or her
parents, siblings, friends, etc., which helps therapists understand what
barriers might impede treatment progress.

d. Training

DBT therapists are required to take a specialized training program that

involves 20 hours of training in DBT. Therapists can then attend one
additional course and participate in continuing education (CE). These
principles include:

a. Assessing problematic psychosocial issues. This includes assessing the

individual's interpersonal relationships, social skills, and other important
issues contributing to their condition.

b. Developing a treatment plan for the client. This entails identifying

strengths and weaknesses and developing goals for treatment that will help
them achieve optimal functioning.

c. Identifying target behaviors related to their problems, building on

strengths, and assessing readiness for change using outcome measures
developed by the DBT team (e.g., act intended, frequency, intensity, etc.).
These behaviors include self-damaging and those that interfere with social
functioning.

d. Treating the client using cognitive and behavioral therapy techniques

tailored to the individual's needs and preferences.

e. Working with the client to overcome obstacles to success, including

therapy refusal, medication noncompliance, in-session behavior problems,
and disruptions in therapy due to crises or self-injury.
f. Following up with clients after they have been discharged from treatment
by conducting telephone contact and evaluating treatment outcomes using a
quantitative assessment measure (e.g., BPD rating scale or SIBRI).

g. Developing written protocols for use by other providers.

h. Advising and coordinating mental health services for the individual and
their family members.

i. Providing appropriate case management to patients under the supervision

of a licensed mental health professional in collaboration with the individuals
and families affected by their condition, as well as appropriate community
resources and social service agencies.

j. Ensuring that every client receives routine physical checkups, drug

therapy, and medication education to maintain an optimum state of health
during treatment and recovery from illness or injury while under general
medical supervision or on restricted medication that does not interfere with
DBT training or practice.

Patients with BPD have an extremely high prevalence of social phobia.

Social anxiety disorder (SAD) and psychosomatic illnesses are often
associated with BPD. For example, people with SAD frequently have
"attempted suicide because of rejection by others and had racing thoughts,
feelings of terror, and physical symptoms such as sweating and blushing."
Furthermore, research suggests that BPD patients often believe that they
are physically weak compared to other people and therefore avoid social
situations.

DBT aims to improve social functioning by teaching patients to control their

emotions in stressful situations without externalizing their negative
emotions or engaging in self-destructive behaviors (e.g., self-injury). The
"Interpersonal Effectiveness skills" focus on helping patients communicate
effectively with others and to listen more skillfully. The ultimate goal is to
become emotionally independent and free from the various problems
associated with BPD.

DBT has been tested in two RCTs conducted by psychologist Marsha

Linehan and her colleagues. These trials showed that DBT could be
implemented successfully in a psychiatric setting, producing significant
reductions in suicide attempts, self-injury, and substance abuse among
participants with BPD. The first trial compared DBT to treatment as usual
(TAU), a practice that does not specifically target BPD but includes regular
visits to a psychiatrist or psychotherapist and often hospitalization for
severe crises.

Types of DBT
Some professionals have developed their versions of DBT. These variations
are known as "off-label" applications of the treatment. This means they have
modified the original treatment in some way to meet their own needs and
the needs of their clients. An example is "Third Wave DBT," designed by
psychologist Paul T. Mason, which in addition to the standard DBT program,
also includes meditation, acceptance techniques, and cognitive therapy
techniques.

Treatment costs depend on where treatment is administered and what kinds

of treatments are available. For example, training a therapist to provide
DBT could cost several hundred thousand dollars, but group sessions may
be more cost-effective over the long term. Due to the nature of BPD and its
co-existing disorders (depression and suicidal thoughts) and psychiatric and
drug dependence, many patients cannot work during the acute phase of
their recovery. As patients become healthier and more stable, they may join
a part-time or full-time job to help fund future sessions.

The cost of DBT for an individual with BPD has not been determined, but
the overall cost to society is high. BPD often goes undiagnosed or
misdiagnosed, and patients are often in and out of mental institutions,
hospitals, or jails. Although the disorder has a high prevalence rate, many
people with BPD are never treated; thus, many go undiagnosed.

The name "dialectical behavior therapy" comes from dialectics and behavior
therapy. It has dialectical elements in that it views the patient's difficulties
as existing in a systemic and relational context.

Types of DBT include:

1. Individual DBT
This is where an individual, or the RT, works with a therapist to help them
manage their emotions and regulate their behaviors to reduce self-harming
and suicidal behavior.

2. Group DBT

Groups of 3-5 people dealing with BPD are designed to help build
awareness about different situations/problems. A therapist leads the groups,
but participants also take on leadership roles. "The broader goal of group
DBT is not only symptom reduction but also the enhancement of the
patient's quality of life."

3. Phone coaching (called "phone-DBT")

This is an element of individual DBT but also an expansion of the whole

system of DBT. It involves training the patient to communicate better with
the therapist by setting up appointments via phone, text messaging, or
Skype video calls.

4. Functional assessment

This part aims to help the patient identify problems, feelings, and actions
that are negative, painful, and irrational to help them change their thinking
and behavior. Additionally, this helps them manage their emotions and
regulate their behavior for those emotions not to trigger harmful behaviors
such as self-harm or suicidal behavior.

5. Distress tolerance

This is another tool to help the patient better manage their emotions, which
helps them avoid engaging in behavior that is unwanted and unhealthy.

6. Email coaching (called "email-DBT")

This part of DBT involves sending the patient helpful homework

assignments through email. Moreover, email-DBT is the only part of DBT
that the patient can receive via email.

7. Provision of services

This is a way to help the patient find employment or other ways to support
their recovery and maintenance in DBT.
8. Modification of supervision

The patient's therapist can adjust the training between sessions as long as it
does not cause harm to the progress made in therapy. Examples include
giving additional homework assignments or discussing changes with the
patient, but leaving it up to them on what will be discussed and how long
should be spent on each issue.

9. Mindfulness

This is a technique used to help people better manage their emotions and
regulate their behavior. The patients are taught how to develop an
awareness of emotion without having strong emotions, which can lead to
problems such as self-harm or suicidal behavior.

10. Acceptance

In this section, the therapist works with the patient to accept situations they
cannot change or overcome. This also helps them learn how to be more at
ease with whatever is happening around them by learning to accept the
situation and not take it personally.

11. Mindfulness of self

This is a way to help people overcome their internal dilemmas, such as

emotional and behavioral abuse, by learning to be more aware of their
thoughts and feelings. This also helps patients become more in control of
their emotions and behavior.

12. Parenting

In this area, parents are taught how to communicate better with their
children, talk about feelings instead of avoiding them, and teach the family
coping skills at home.

Dialectical Behavior Therapy successfully reduces symptoms of BPD (e.g.,

suicide attempts, impulsivity). This has led many experts to endorse its
application as an effective tool for the treatment of individuals suffering
from BPD.
 DBT vs. CBT
These are the two most common types of talk therapy, and they're both very
helpful for people struggling with depression, anxiety, or addiction. Both
types of talk therapy help you to express your feelings healthily, but DBT
has one major difference. Unlike CBT, DBT helps you identify what is going
on in your behavior and figure out how to change it accordingly.

If you are struggling with any emotional or mental health problem -

especially if it's been ongoing for a long time - talk about your situation with
someone specializing in DBT. It might not have worked for everyone else
that tried it before; talking about your situation might bring up some new
insights that were impossible until then. DBT is one of the most effective
treatments for severe mental health disorders and can change your life.

DBT is one of the most effective types of talk therapy for helping people
with chronic psychiatric or emotional problems such as depression and
anxiety. It is a cognitive behavioral therapy that teaches people skills to
cope with stressful situations and how to avoid using dysfunctional coping
strategies (like self-harm). DBT talks about two different types of coping
strategies: emotion-based coping strategies and problem-solving strategies.

Emotion-based coping strategies include talking yourself into being content

or distracting yourself from your emotions. Problem-solving strategies are
ways of directly addressing the problem, such as telling the person you
dislike that you'd like them to change. DBT teaches people how to use
emotion-based strategies because it's not always possible or even
appropriate to try solving the problems that cause their emotional issues.
Some problems just can't be solved, and helping someone to face that
reality is necessary for long-term success in psychiatric therapy. Emotion-
based coping strategies might seem like they're helping you, but they end
up causing more problems. For example, when you're already feeling
depressed, you might think it's a good idea to distract yourself from your
emotions and distract yourself with something fun. So you go to the mall or
do something fun with your friends. But when you come home and face the
reality of what's left in your life, those distractions cause more depression
instead of relieving it.
DBT is based on the work of psychologist Marsha Linehan and cognitive
therapist David Tuller at the University of Washington. Linehan developed
the program in the 1980s to help individuals with borderline personality
disorder (BPD). Now, DBT is used to treat people struggling with eating
disorders and depression and those at risk of suicide. The type of treatment
often requires a certified DBT therapist to administer, so make sure to find
one who is well-trained and experienced.

DBT's goal is to teach people skills that can help them shift how they think
about their problems and increase their ability to cope with them. The goal
is not necessarily a quick fix but a long one that works over time.

Why Choose DBT over CBT?

One of the main differences between CBT and DBT is that CBT is an
external approach to handling mental health, while DBT has an internal
focus. DBT does help clients identify things that are causing their behaviors,
but it's not going to solve them for you. Instead, it's more helpful for people
who need new coping methods to deal with their problems.

DBT creates a holistic approach to life management by teaching you how to

handle stress better and how to deal with your emotions at the moment so
that you can make smart decisions about the future instead of impulsively
reacting without considering your options.

What are the main differences between DBT and CBT?

DBT is more focused on teaching clients problem-solving skills to improve

their emotional state. CBT is more focused on identifying the symptoms of
mental illness and improving outcomes.

This quote summarizes the primary difference between both treatments:

"CBT seeks to change dysfunctional thinking, whereas DBT seeks to change
dysfunctional behaviors."

Therefore, both therapies have been beneficial in treating people with a

history of severe depression and anxiety. However, some patients may find
that one approach works better for them than the other.
DBT, like CBT, also focuses on helping people recognize their symptoms
and find the root of stress.

DBT attempts to help them build a healthier coping mechanism and reaction
to everyday problems.

This process can take time, as different patients respond differently to

treatments. The long-term goal of DBT is for people struggling with mental
illness to cope with problems healthily when their negative or dysfunctional
behavior patterns are triggered.

When you compare DBT vs. CBT, you need to remember that both therapies
use mainly cognitive techniques to help patients develop a healthier
thinking pattern that will gradually lead them out of their unhealthy cycle of
depression or anxiety.

CBT is a "top-down" approach that requires patients to change their

behavior and learn new coping mechanisms. DBT is a "bottom-up"
approach, however, which teaches patients how to handle stress better in
the first place.

One of the biggest benefits of DBT is that it focuses on helping people

develop healthy behaviors from an early stage – instead of just teaching
them to hold in their emotions until they feel better about them.

DBT does not focus on changing your thinking process as much as CBT
does. Instead, DBT seeks to help people change their reactions to external
stressors and habits instead of just changing their thinking patterns. The
goal of DBT is for patients to "act" on the tools and techniques they learn
instead of just learning them passively.

Cognitive behavioral therapy (CBT) often means psychotherapy that works

by focusing on a person's thoughts, behaviors, and beliefs. The therapist
will help you identify the thoughts and feelings that can cause or worsen
your depression or anxiety, change how you react to those negative
thoughts, and teach you how to develop positive alternatives.

CBT works to enable you to assess situations realistically and then take
steps to change the way you feel and behave. This might include
challenging your reactions, learning to relax and control your emotions, and
changing how you respond to difficult situations.

It's not a quick fix, but it can give you the tools that allow lasting positive
change.

When a person is depressed or anxious, they are often consumed by their

negative thoughts and feelings.

Cognitive behavioral therapy teaches patients how to identify those

thoughts and then let them go so they can focus on the present moment
instead of being stuck in the past.

An example of this would be recognizing when you are using food to cope
with anxiety, then identifying specific ways you could let go and find new
healthy ways to cope.

CBT is focused on correcting the thoughts that cause symptoms of

depression and anxiety, while DBT is focused on changing behaviors that
create those same symptoms.

CBT makes sure you know how to recognize thought patterns that often
lead to depression or anxiety becoming more severe. Then, DBT teaches
people how to avoid these patterns in the first place.

This can be more challenging for some people since it's easier in the short
term to just let negative thoughts and feelings flow through you, but it's not
always healthy or sustainable in the long term.

Moreover, some more differences between CBT and DBT are:

a. Much like CBT, DBT uses the tools of Dialectical Behavioral Therapy.

b. In DBT, commonly used tools are homework assignments, a daily log, and
an... "daily review" session.

c. Whereas CBT focuses on re-establishing a healthy balance between mood

and thought patterns, DBT is more focused on maintaining a healthy
balance in relationships as well as one's own emotions.
d. While CBT usually takes place in a room with other clients, DBT takes
place in a private studio environment with the therapist but without any
other clients present for confidential issues to be discussed.

e. CBT focuses more on the individual patient and their patterns of thought.
At the same time, DBT focuses more on the relationships between family
members and issues that might restrict individuals.

f. While CBT teaches patients how to identify their negative thought

patterns and then let them go, DBT helps them recognize negative
behaviors and then work to change them for the better instead of just
identifying them as negative.

g. CBT focuses on helping patients find practical ways to cope with feelings
associated with depression or anxiety. In contrast, DBT focuses on changing
those reactions so that you can let go of depression or anxiety-inducing
feelings in their entirety.

h. Therapists in CBT focus on helping a patient understand their issues and

how those issues may affect other relationships, while therapists in DBT
focus more on the person's interactions with others.

i. CBT aims to encourage patients to develop new coping patterns and

behaviors that will help them maintain a healthy lifestyle and lifestyle
balance by addressing negative cycles or patterns of thoughts or behaviors
that often lead to depression or anxiety. DBT aims to address interpersonal
relationships between family members and develop healthy behaviors for
each family member.

j. CBT focuses more on teaching patient-specific patterns of thinking that

cause depression or anxiety. In contrast, DBT focuses more on teaching a
patient specific patterns of behavior that lead to depression or anxiety.

k. CBT is more heavily focused on cognitive behavioral therapy, while DBT

is more focused on addressing the issue at the core of depression or
anxiety.

l. CBT encourages a patient to recognize ways that depression or anxiety

might affect relationships and then work to strengthen them. DBT's goal is
for patients to learn how to change their interpersonal relationships and
improve their health.

m. CBT seeks to help patients recognize patterns in their thoughts or

behaviors that lead to depression or anxiety and find healthier ways to cope
with those feelings.

How Does DBT Work compared to CBT?

The acronyms DBT and CBT both represent terms that have become
popular in the field of mental health. So what's the difference between DBT
vs. CBT? Does one of them work better than the other?

Cognitive behavioral therapy (CBT) developed from a much older school of

psychotherapy called rational emotive behavior therapy (REBT). The goal of
REBT is to help clients recognize faulty, irrational thought patterns and
replace them with more helpful, realistic ones. It was developed by Albert
Ellis (originally trained as a psychoanalyst), who ultimately wanted to take
REBT to more extreme lengths without losing its therapeutic effectiveness.
So Ellis created a system that would allow people to identify faulty,
irrational thought patterns and replace them with more realistic, helpful
ones. The learning of this new therapy propagated quickly, and several
other therapists invented their systems based on Ellis's model. The most
well-known is probably Aaron Beck's cognitive therapy, which models Ellis's
method but emphasizes behavioral therapy.

Cognitive behavioral therapy (CBT) is the more recent school of

psychotherapy. It was developed by Aaron Beck, who envisioned it as an
alternative to Ellis and other versions of rational emotive behavior therapy
that were being practiced at the time. CBT is a form of structured therapy,
not to be confused with psychoanalysis. It models several approaches and
techniques to help clients achieve certain goals or work through specific
issues. There are several different varieties of CBT, all of which have been
developed based on Beck's initial model.

While cognitive behavioral therapy (CBT) can be seen as a subset of

cognitive therapy (CT), dialectical behavior therapy (DBT) represents an
offshoot from CT and REBT that has since been proven effective for patients
with Borderline Personality Disorder (BPD).
Cognitive therapy is based on the idea that certain thoughts and behaviors
can trigger negative emotions. Therefore, by changing these thought
patterns is believed that a patient's problematic emotions can be reduced or
eliminated.

Likewise, DBT teaches patients how to identify patterns in their thinking

and then replace those thoughts with healthier ones. In addition, DBT
emphasizes helping patients develop the social and life skills needed to deal
with their emotions and change for the better.

CB therapists focus on minimizing a patient's tendency towards negative or

unhealthy thoughts by addressing them head-on rather than just identifying
them by name. However, DBT therapists are more concerned with the fact
that those thoughts and behaviors often lead to unhealthy emotions and the
ways those emotions may act on a person's relationships.

DBT therapists are concerned more with helping patients learn new ways to
cope with their negative reactions rather than simply identifying them as
negative. In this way, DBT is more closely related to cognitive therapy and
REBT. Both forms of therapy focus on helping patients identify problems
that recurring negative thoughts might have and then replace them with
new ones that can lead to healthier emotional responses. But while
cognitive therapy focuses largely on teaching patients how to change their
thought patterns, DBT tries to teach them how to change their behavior
patterns.

While cognitive behavioral therapy (CBT) is still seen as one of the most
effective forms of depression treatment, dialectical behavior therapy (DBT)
has also proven effective in treating patients with Borderline Personality
Disorder.

From the 1960s, Ellis's rational emotive behavior therapy (REBT), inspired
by the psychoanalyst Sigmund Freud and Albert Ellis, was originally
designed to treat various psychological issues. Still, it was soon discovered
that it worked best for treating depression. The method taught patients how
to change their thoughts and behaviors to minimize their symptoms.
However, Ellis later created a more extreme version of REBT called
"rational therapy." Unlike REBT, rational therapy teaches patients how to
change the world instead of their thoughts. The method was later renamed
just rational emotive behavior therapy, but it was soon discovered that to
change one's reality, one must first change their thoughts.

Rational emotive behavior therapy (REBT) is based on three different

principles:

1. The principle of humanism: humans are responsible for their own

emotions and actions at all times. No outside forces or events can cause you
to feel or behave a certain way unless you allow them to do so.

2. The principle of environmentalism: You are responsible for making the

world as pleasant and enjoyable as possible while still behaving morally.

3. The principle of the science of self-knowledge is that the only way to

understand yourself truly or others is by applying reason and logic.

As REBT matured, it also began to develop several branches based on slight

variations in technique and theory. Most notably, Albert Ellis developed
rational emotive behavioral therapy (REBT) by removing the emphasis on
changing one's external environment, which allowed him to focus more on
helping patients change their thought patterns. He also emphasized that
while a patient's feelings can be rational, the thoughts leading to those
feelings are often irrational. Thus, REBT is a combination of cognitive and
rational emotive behavior therapy (REBT).

It wasn't long before other therapists adopted Ellis's new method. Still, they
soon began creating their treatment systems based on his system, and thus,
various versions of rational emotive behavior therapy were created and
developed. Included among these are:

Ellis' theory and practice influenced later theorists such as R.D. Laing,
David D. Burns, Albert Einstein, and Carl Rogers. REBT theory and practice
are also used extensively in self-help books, workbooks, and computer-
based cognitive behavioral therapy programs.

Albert Ellis's Institute for Rational Living still exists in New York City, San
Diego, and San Francisco. The institute offers free lectures on Thursdays at
8 pm, which anyone is welcome to attend.
REBT is seen as a more extreme form of CBT that views irrational thinking
as the root cause of most human suffering. REBT therapists believe that
almost every behavior stems from an irrational thought or belief held by the
individual, which means that if you can change those thoughts, you can
change their behavior.

Therefore, REBT therapists concentrate on helping patients identify the

irrational thoughts that lead to irrational behaviors and then teach them
how to change those thoughts and behavior to reduce their negative or
unhealthy emotions.

REBT is sometimes called dialectical or Ellis method cognitive therapy. This

is because it uses principles from cognitive therapy but also REBT. Both are
based on the idea that people's problems stem from irrational thinking, and
both use cognitive therapy techniques such as "logic" exercises, correcting
thought errors, and challenging extreme beliefs.

Similarities between DBT and CBT

These similarities between DBT and CBT have led to the integration of DBT
techniques in many current-day Cognitive Behavioral Therapy (CBT) types.

•DBT and Cognitive Behavioral Therapy (CBT) are founded on the belief
that an individual's thoughts affect their feelings and behavior.

•Both therapies believe that it is important to understand your current

situation, analyze the way you think, and learn new alternative methods to
deal with problems.

•Both therapies attempt to help clients change their lives by changing their
thoughts, feelings, or behaviors.

•Both seek to empower patients by giving them skills necessary for them to
be successful in life.

•Both therapies use behavioral and cognitive techniques to accomplish this

goal.

•Both therapies are meant to be a safe place to explore one's surroundings

and acquire new skills.
•Both therapies recognize the importance of values or morals in everyone's
life.

Reasons for integration of DBT into existing and newer CBT programs

These are the reasons why DBT has led to it being integrated into newer
and existing cognitive behavioral therapy programs:

•DBT is a complementary therapy in many areas because it can help with

issues such as suicidal thoughts, depression, anxiety, anger, addictions, co-
dependency, interpersonal relationships, etc.

•DBT helps the patient learn many skills and ways of coping with their
surroundings, which cognitive behavioral therapy can also do.

•The functional approach to therapy is based on the belief that patients with
BPD can learn many skills which enable them to break out of their
dysfunctional cycles, control their emotions and behaviors, and improve
their quality of life.

•Overcoming your symptoms can be accomplished by teaching you how to

regulate your emotions healthily.

•When working with clients, you focus on the present instead of worrying
about the past or future. This therapy gives you a chance at life again,
instead of having your life ruled by thoughts and feelings that keep you
from living.

•DBT is based on the idea that all people's symptoms are due to their
thoughts, feelings, and behavior. Therefore, DBT can help people with BPD
make positive changes in their thoughts and feelings.

• To treat clients, you must understand their symptoms, how they may
occur, and how they got to be. This allows the therapist to help lead them
through healing and recovery.

•DBT aims to teach clients a healthier lifestyle that works for them. This is
accomplished by working with the client to create a life skills program.

•With DBT, you can help clients be aware of their strengths and weaknesses
and teach them how to identify the negative influences in their lives. This
enables them to begin working on themselves and their issues in the
present moment.

•DBT aims to prevent suicide and self-harm behaviors that may be caused
by emotional, cognitive, biological, or environmental factors.

•With DBT, you can also work on a client's mood swings and unstable
emotions that may occur from time to time as part of BPD.

•DBT teaches clients how to identify the secondary gains they may
experience from their symptoms and how to solve future problems by taking
advantage of relationships or situations.

•In a DBT session, you can talk about emotional issues in the present
moment with your partner in a very non-threatening, non-judgmental
manner.

•DBT can target many different areas of functioning, including

interpersonal functions, role functioning, family relationships, sexual
intimacy, daily living skills, recreation activities, work and school
achievement, and social interactions.

Therefore, CBT and DBT are similar in that they help with issues of
emotion, relationships, and mood. They both also focus on working on all
these areas simultaneously with a bigger goal in mind. Moreover, they use
techniques to meet these goals, such as behavioral exercises, skills training,
and exposure therapy.

Cognitive behavioral therapy is part of a broader cognitive behavioral

therapy (CBT) approach. The other well-known member of this family is
Dialectical Behavior Therapy (DBT). DBT was initially used for treating
Borderline Personality Disorder (BPD), but it has now been validated for
various psychological and mental disorders.

Because DBT adopts the same theoretical framework as CBT, many

elements from the latter are also found in the former. In fact, by following
the same principles and procedures, CBT and DBT overlap greatly in what
they aim to achieve. Specifically, they both attempt to tackle the client's
problematic feelings and behaviors by changing the way they think—albeit
in different ways.
Regarding origins, CBT and DBT began their journeys in the 1960s and 70s,
respectively. These two therapies are considered to be part of the second
wave of cognitive behavioral therapy, along with Dialectical Behavior
Therapy (DBT), Rational Emotive Behavioral Therapy (REBT), Interpersonal
Therapy (IPT), Family Focused Treatment for Borderline Personality
Disorder (FFT-BP), and Motivational Interviewing (MI).

Many similarities exist between these different therapies due to how they
were initially developed. For example, all originated from the same group of
therapists—those who originally developed Cognitive Behavioral Therapy
(CBT).

Similarly, many of these therapies originated from the same source—Albert

Ellis and Aaron Beck. These two influential figures developed Rational
Emotive Behavior Therapy (REBT) and Cognitive Behavioral Therapy (CBT).

As a result, it is unsurprising then that both DBT and CBT are rooted in
these two pioneers' work. In addition, both DBT and CBT stem from Albert
Ellis' approach to psychotherapy, known as Rational Emotive Behavior
Therapy (REBT).

Albert Ellis was one of the main people involved in developing CBT,
particularly Rational Emotive Behavioral Therapy (REBT).

Is DBT Effective compared to CBT?

DBT is effective in treating borderline personality disorder compared to

CBT. Therefore, a study was conducted in 2005 to compare the
effectiveness of DBT, EMDR, and CBT treatments (jointly called ABT). Using
a randomized controlled trial design, 80 patients were randomly assigned to
one of the three groups. The participants were evaluated over six months:
at the start of treatment, mid-way through treatment, and two weeks after
completion. After this evaluation period, it was determined that both DBT
and CBT were equally effective at reducing borderline personality disorder
symptoms.

Since the widespread use of DBT is increasing in many countries worldwide,

there is a need to determine its effectiveness as a treatment for borderline
personality disorder. Therefore, the effectiveness of DBT was compared to
individual and group CBT in a randomized controlled trial. The participants
included 27 adults with borderline personality disorder (BPD) who
participated in DBT and 27 adults with BPD who participated in individual
and group CBT.

The participants were evaluated at the start of treatment, mid-treatment,

and two-week after treatment ended. Both DBT and CBT significantly
improved the participants who exhibited severe BPD symptoms and those
with moderate BPD symptoms. However, individuals who received DBT had
significantly fewer hospital days than those in the other groups.

Most studies focused on DBT have been conducted in Germany, as more

DBT therapists have been located there. This country also has more
psychotherapists trained in CBT than any other country in Europe.
However, the same findings were found in other countries where DBT was
used to treat BPD and other personality disorders.

The evaluation of treatment outcomes often includes measurements of

improvement in mood, anxiety, and other areas of functioning. In addition,
other measures like hospitalizations are sometimes included if severe
disruptive behaviors or severe emotional distress are present at the
beginning of the treatment period.

For one study, individuals randomized to psychoeducation (which could

represent either DBT or CBT), in addition to their usual treatment, did not
have an increased concurrent risk of hospitalization compared with usual
treatment alone. However, this study was conducted in the Netherlands at a
psychiatric outpatient clinic serving individuals with severe and persistent
mental disorders; it did not evaluate DBT or test whether psychoeducation
was an effective intervention for borderline personality disorder.

The effectiveness of DBT can be compared to that of CBT through a

randomized controlled trial. This study was conducted in the United States
on individuals with borderline personality disorder experiencing higher
maladaptive behaviors (e.g., self-injury). Participants were randomly
assigned to DBT, a version of DBT that included family participation or CBT.
All participants underwent treatment for approximately two years, and all
groups showed significant improvements from baseline to the end of the
study. In addition, those who received DBT had fewer self-injury crisis days
during and after treatment than those who received CBT.

Diversity has long been acknowledged as a fundamental premise in

scientific research and practice. The role of minority groups in the
development and future of DBT is worthy of special consideration. Many
barriers need to be examined to reach diverse populations successfully. The
therapist should distinguish between cultural diversity and individual
differences when dealing with each patient’s different needs. This
differentiation is one-way therapists can increase their understanding of
their patients and improve their treatment.

Cultural diversity can be defined as differences in thought, perception,

values, and behaviors across different groups, especially ethnically diverse
groups within a population. While most DBT specialists are Caucasian,
therapists must recognize cultural diversity in individuals from different
ethnic backgrounds.
 The basics of DBT
Dialectical Behavior Therapy (DBT) is a form of psychotherapy developed to
help people with chronic emotional instability, like Borderline Personality
Disorder. DBT was designed to be an alternative to traditional talk therapy,
which relied primarily on verbal communication between therapist and
client.

DBT is based on the principles of Dialectical Behavior Therapy, which

applies a scientific approach to eradicate and prevent emotional disorders
in the individual by identifying and modifying distorted thinking patterns
and behaviors.

The main distinguishing feature of DBT is the use of two core skills:
Mindfulness and Distress Tolerance. These are combined with several
therapeutic approaches and tools, such as behavioral exercises,
mindfulness-based practices, and family therapy. These methods help
people learn how to regulate emotions, protect themselves against disorder
relapse, and lead more functional lives.

DBT can be implemented differently depending on the patient's needs and

the available resources. Individual DBT (iDBT) is the preferred approach,
but group DBT (gDBT) is also used. In addition, a Partial Hospitalization
Program (PHP) or Intensive Outpatient Program (IOP) may be required.
There are several standardized treatment manuals for each method of DBT.

Insurance coverage for DBT varies widely throughout different parts of the
world and in different health care plans. Insurance companies often do not
cover it; hence, this type of psychotherapy can be prohibitively expensive.
In some cases, medication and psychotherapy have been used to treat
depression and anxiety disorders.

The DBT approach assumes that the skills learned in therapy, including
mindfulness, distress tolerance, emotion regulation, self-management, and
interpersonal effectiveness, will help patients achieve more effective and
adaptive behaviors and lead a more meaningful life. The authors of DBT
note: "DBT is not limited to treating BPD; it has been applied successfully to
a range of problems associated with chronically suicidal and parasuicidal
behavior."
The origin of Dialectical Behavior Therapy can be traced to the philosophy
behind Zen Buddhism. In "Zen and Japanese Buddhism" (1938), D.T. Suzuki
posits that humans develop perceptions through subjective experiences.
This corresponds with the "subjectivist" approach in Dialectical Behavior
Therapy.

Several philosophical and therapeutic traditions have considered the

concept of dialectics or dialectical thinking, including ancient Greek
philosophy, Buddhism, and Taoism. Hegel coined the term. In practical
terms, dialectic refers to an approach that refuses to accept a rigid
dichotomy between two opposing concepts (e.g., suicidal vs. not suicidal),
instead considering them as two extremes on a continuum that can be
reconciled (e.g., less vs. more suicidal). In DBT, this dialectic approach
applies to both clinical depression and BPD. John Rolland, a DBT pioneer,
considered one of the fathers of DBT in psychology, wrote about how DBT
applied dialectics to clinical practice: "Dialectical behavior therapy is rooted
in dialectics. The person-centered approach grows out of the emphasis on
seeing different parts as different aspects of an integrated whole. This
perspective has yielded a style and set of inherently dialectical strategies."

Common Deficits of Behavior

Behavioral deficits are the observable behavior problems of a person. These

deficits include, but are not limited to, problems with communication skills
and behaviors that interfere with relationships and work productivity.
Behaviors can either be aspects of a disorder or learned habits favored by
the individual but may be disadvantageous or distressing to themselves or
others.

Many behavioral deficits are associated with people diagnosed with a

personality disorder, such as borderline personality disorder. Some of these
deficits include impulsivity, self-harm, risk-taking behaviors, tantrums and
mood swings (in the case of BPD), irritability, suicidality, self-neglect (e.g.,
hoarding), and reckless behavior (such as substance misuse). However,
primary deficits are the behavioral problems present in the first year of a
person's life before they develop a personality disorder. These primary
deficits include emotional regulation and dysregulation, communication
skills, and reward/punishment systems.
Borderline Personality Disorder is often characterized by several emotional
dysregulation issues, including but not limited to impulsivity, affect
dysregulation (e.g., explosive anger), self-harm/suicidal behavior, phobias
(e.g., fear of abandonment), substance misuse, and risk-taking behaviors for
pleasurable effects (e.g., sexual indiscretions). Most of these issues are very
distressing for individuals with BPD, their family members, and their
friends. Yet Borderline Personality Disorder is rarely formally diagnosed
until the person is an adult. It is, therefore, a personal choice whether or
not to seek professional help using a service such as the "Online Doctor" or
an online therapist.

Therefore, common deficits of behavior in DBT include:

a. Impulsivity

In Borderline Personality Disorder, individuals present with several

emotional dysregulation issues, including but not limited to impulsivity, fear
of abandonment, and explosive anger. Therefore, common deficits of
behavior in DBT include: Planning as a goal to set yourself and others up for
success by weighing all possibilities when making decisions. In addition,
tolerance for uncertainty can be achieved by developing skills such as
perseverance and being willing to hold on to long-term goals. For example,
e met. "I'll be punished if I don't keep pushing this project forward."

b. Communication skills

Individuals diagnosed with BPD often present with several emotional

dysregulation issues, including but not limited to: difficulty initiating or
maintaining relationships, conflict and irritability in the presence of others,
and a tendency to sabotage relationships and work productivity. Therefore,
common deficits of behavior in DBT include: "It's not that I'm bad at
communicating; it's that I'm terrified of getting it wrong."

c. Mood swings

A person diagnosed with BPD may present with several emotional

dysregulation issues, including affective instability (e.g., intense mood
changes and irritability), self-mutilation, and suicidal behavior. Therefore,
common deficits of behavior in DBT include: "I don't have a normal mood-
swing cycle. I can be angry for no reason. They're just taking me as I am."

d. Suicidality/self-neglect

Individuals diagnosed with BPD present with several emotional

dysregulation issues, including but not limited to: planning and monitoring
their functions, difficulty with emotions and interpersonal relationships,
suicidal ideation, and impulsive self-harm behaviors. Therefore, common
deficits of behavior in DBT include: "I have to keep the house clean and tidy
for my mother so that she'll feel comfortable."

e. Risk-taking behaviors

Individuals diagnosed with BPD present with several emotional

dysregulation issues, including but not limited to: cutting, substance
misuse, and risk-taking behaviors that are used to cope with anxiety (e.g.,
over-eating/binge eating, sexual indiscretions). Therefore, common deficits
of behavior in DBT include: "I'm just identifying how I can use the coping
skills I've been learning."

f. Irritability

Individuals diagnosed with BPD present with several emotional

dysregulation issues, including irritability and anger in the presence of
others, tantrums, and intrusive/intrusive behaviors (e.g., jealousy).
Therefore, common deficits of behavior in DBT include: "I have to hold my
tongue when I'm angry."

g. Anger

Individuals diagnosed with BPD present with several emotional

dysregulation issues, including but not limited to: explosive anger,
dissociation, and difficulty regulating emotions in the presence of others.
Therefore, common deficits of behavior in DBT include: "It's not that I'm
angry all the time. It's just that I can't control my anger."

Common Deficits of Behavior are defined as the observable behavior

problems of a person. These deficits include, but are not limited to,
problems with communication skills and behaviors that interfere with
relationships and work productivity. "Impulsivity" is the most commonly
cited deficit of behavior in DBT clients who present with an emotion
dysregulation disorder. High impulsivity has important implications for
treating emotion dysregulation because it can significantly increase the
severity of associated symptoms such as aggressive behavior. Self-harm
behaviors (e.g., attempting suicide) are also frequently present among
people diagnosed with a personality disorder like BPD. Still, they are very
difficult to treat, especially when they become a chronic behavioral
problems like self-harm behavior (e.g., cutting).

Clients diagnosed with BPD present a variety of emotional dysregulation

problems, including but not limited to: anxiety, fear, anger, impulsivity, and
self-harm/suicide. "Emotions are not something you can control," Louis
Swift said. "I think it is important for all of us to acknowledge that emotions
are real and that they affect your behavior," he continued, "and that the
solution isn't to push them away or try to suppress them." The ability to
regulate emotions effectively in the presence of others has great
implications for friendships or professional relationships.

The Relapse Prevention Plan

The Relapse Prevention Plan can be used to assist individuals in acquiring

and strengthening adaptive behaviors. Relapse prevention plans are
designed to prevent future relapses of the behavior problems that are the
focus of treatment, which can significantly reduce suffering and improve
quality of life.

Self-harm is a behavior problem associated with Borderline Personality

Disorder.

Relapse prevention plans consist of three distinct steps: (1) setting specific
goals and (2) planning how to achieve them, along with a list of possible
situations that might trigger relapse; (3) observing emotions and generating
coping statements and coping skills before you need them.

In the rest of this manual, the results of a relapse prevention plan for self-
harm are used as an example of how a DBT client might use DBT skills to
reduce aggression, harm, and self-harm risk.
The relapse prevention plan for self-harming is: (1) I will set specific goals,
and (2) I will list hypothetical situations that could cause me to engage in
self-harm. (3) I will observe my emotions, generate coping statements and
coping skills, and decide on a course of action before I need them.

In DBT, "psychological flexibility" is the ability to be effective in various

situations.

Awareness of thoughts and emotions in the presence of others, during

physical activity, and when performing routine tasks can enhance
psychological flexibility. The need for psychological flexibility becomes
apparent when an individual's emotions do not support or contribute to
constructive or proactive behaviors, such as goal-directed behaviors and
healthy lifestyles.

How to do DBT
The key to using DBT successfully as a resident is to learn the skills and
practice on your own to have some skills in place (as much as possible)
when you start seeing a therapist. You can find free training videos on
YouTube and go through the most basic ones to get an idea of how DBT
might help you. You may also want to join the DBT online chat group to ask
questions. A good therapist will not discourage you from checking out DBT
for yourself if you are already thinking about it with or without a referral
from them. Then, if DBT does seem promising, go ahead and do the full
course of Mr. Linehan's recommended treatment (DBT-LITE). Ask a few
therapist questions to assess if they will be compatible with you (how often
they attend weekly therapy, how much of it is focused on skills, their goals
for therapy, etc.). Ask about the target audience for DBT. Again, note that
DBT is not just intended for people with serious mental health problems. It
is also intended for people with moderate to severe chronic illness and
substance abusers who voluntarily want to change their lives (which is why
it can be so effective).

The DBT manual does not provide any specific implementation guidelines
and does not prescribe a specific frequency or amount of individualized
therapy sessions. At least some therapists do not follow this guideline.
Before committing to DBT, find out how many individualized therapy
sessions the therapist offers. Also, find out if DBT skills groups are available
in your area or by phone, or at least an individual therapist who will do a
telephone consultation. In some (but not all) areas of the US and other
countries where DBT is used, a typical program will consist of a
combination of individual sessions with a therapist and weekly support
group meetings that are usually run by someone other than the therapist
who works primarily with individuals.

Some people have a hard time getting into an individual therapy session.
The therapist may offer telephone consultation sessions, or you may be
referred to a DBT provider with a community-based practice. In addition,
you can find good therapists via word of mouth. For instance, you might get
a referral from your primary care physician or mental health providers, or
by searching the internet for a "DBT Therapist."

Some therapists choose to combine individualized therapy with a weekly

support group. Other therapists prefer individualized therapy and may not
see others in their weekly support group meetings.

Therefore, these tips can guide how to do DBT:

a. Ask the therapist how often they attend weekly therapy to continue
learning new techniques and skills.

b. Ask the therapist how often they have individualized sessions with
clients.

c. Check internet reviews of therapists who are good candidates for DBT
according to your needs and preferences, especially any that specialize in
chronic mental health problems like BPD, depression, or substance abuse
that has lasted more than a few years (rather than short-term treatment of
traumatic events or brief reactive episodes).

d. Check if therapists are available for a telephone consultation.

e. Find out what kind of support group meetings will be offered.

f. If a therapist may also be a good candidate for you based on your needs,
compare their therapy style and goals with your preferences.
g. Note that a potential therapist's attitude toward medication may also be
important to you since DBT is integrated with medications in some
programs.

h. Also, note that your habits are also one factor determining how much
progress you will make on your goals. Since many people's habits are not
conducive to good long-term mental health, it may be important to try a new
technique or form of therapy before committing to it.

i. Note that some people find DBT too difficult to do because of their
personality or emotional difficulties, so it would make sense for you to seek
advice from other therapists working with people with emotional distress
before committing to DBT.

j. If DBT does not seem like a good fit for you, ask yourself why and
reconsider if the goal is worth the hassle.

k. You can seek therapy from a therapist through insurance or by paying out
of pocket. In addition, you can search the internet or ask friends and family
for referrals to therapists. Your therapist will give you their credentials and
recommendations concerning therapy sessions, support group meetings,
and achievements in helping people with similar problems as yours and the
eventual outcome of DBT in similar cases.

l. You may be able to find an individual therapist who has more flexible
hours for people who work full time but want to attend therapy at times that
are convenient for them (e.g., Saturday mornings).

m. You can also see if a therapist has other activities like exercise, hobbies,
etc., which they can schedule into their busy schedules so that you will not
feel overwhelmed by their high level of commitment to you. This is
especially important if your therapist is part of a large community-based
practice such as in cities.

If you can attend DBT, try to find one with whom both of you can openly
communicate about the importance of your well-being and be patient and
realistic about what can be done when people are still learning new skills in
therapy.
The conflict between individualized therapy sessions vs. group meetings
may be the most important issue (for people who need more social
interaction).

Managing Thoughts and Behaviors

All of these techniques are designed to change one's behavior and thoughts.
Because this is so important, it can be overwhelming to realize all the
different behaviors involved. Generally, you can divide your thoughts into
three groups:

a. Automatic thoughts

These thoughts stem from your basic beliefs. For instance, you start to think
that you are worthless or somehow bad, even though this is not true. Or you
think that "I always fail," even though this is not entirely true.

b. Emotions

You feel this way because of your feelings and reactions to automatic
thoughts (e.g., shame). You feel bad, angry, ashamed, hopeless, etcetera
because of how you interpret the meaning of these thoughts and their
impact on your emotions and behavior.

c. Behaviors

This is their behavior when people act in certain ways because these
automatic thoughts get them into trouble (e.g., they drink or make sexual
advances inappropriately, or they want to harm themselves). It can also be
your thoughts that cause you to act a certain way and begin to feel bad.

You recognize these thoughts because they constantly pop up in your mind
or tend to be recurrent themes that cause you trouble. You may not realize
why you have these automatic thoughts and how they affect the emotions
you are feeling and the behaviors you engage in (e.g., drinking alcohol).
They may also seem meaningless and without any impact on your life. You
may not notice that they cause you to do things that create more problems
in your life. Therefore, it is important to figure out how these thoughts have
gotten embedded in your brain, why they keep returning, and what kinds of
things could trigger them (if you can find out what triggers them).
d. Both automatic thoughts and emotions are associated with feelings. If
people do not feel bad about themselves, they will not have these automatic
thoughts. So, for people with BPD, emotions can run high, and they over-
generalize how bad an individual feels about themselves because of their
negative beliefs.

If you want to change the behaviors that you engage in (e.g., drinking
alcohol), it is important first to identify why you are doing this (e.g., its
effects on your behavior). This is called a functional analysis or behavioral
assessment. It involves thinking about what happens when you act this way
(e.g., using drugs or alcohol) and what triggers it (e.g., sadness, boredom,
etcetera). It is important to notice that this kind of analysis of behavior
involves paying attention to what happens before you act.

This helps you make sense of your thoughts and behaviors and helps get
more clarity on your behavior (it forces you to take a closer look at things so
that you can see that your automatic thoughts are not always true, nor are
the conclusions about yourself that it draws). The behavior that results from
these automatic thoughts is your response. For example, after an
assessment, if you realize why drinking alcohol makes you think you are
worthless or a loser but realize that it does not have a significant impact on
your life or well-being (e.g., it does not affect your daily functioning), it is
more clear-sighted whether to continue with this behavior or stop doing it.

Some of the main goals of DBT are to learn how to identify thoughts that
lead to automatic behaviors, how these thoughts create emotions (e.g.,
negative emotions), and how they impact the behavior (e.g., drinking, binge
drinking). This is done by:

a. Having a functional analysis or behavioral assessment and realizing the

impact an automatic thought has on your feelings and behaviors (note that
there are many different ways to do this).

b. Understanding which automatic thoughts cause problems in your life and

who you are when you have these beliefs about yourself.

c. Identifying when your automatic thoughts are coming from feelings (e.g.,
shame, anger) and who you are.
d. Identifying which emotions come before you engage in behaviors that
cause problems so that you can have a plan or have the skills to control your
behavior (e.g., "If I feel bad and I think a thought like is true, I will do. This
means identifying how negative beliefs (e.g., "I am worthless") influence
your emotions and behaviors that create these problems (e.g., "If I feel bad,
I will drink alcohol to dull my feelings.").

e. Identifying when your automatic thoughts are coming from a part of

yourself (e.g., "If I feel angry, I will do and being able to recognize these
feelings and why they may come up.

f. Identifying which thoughts trigger behaviors like drinking or other self-

destructive behaviors (e.g., "If I think that I am worthless, I will go out and
drink.").

How Can I Change My Automatic Thoughts relating to DBT?

Understanding the difference between automatic thoughts and emotions

can be important in terms of your self-understanding now as you seek to
achieve a better life.

a. Automatic thoughts are the thoughts that result from all of how you
interpret your pain and difficulties in life.

b. You should be able to identify at least some of these automatic thoughts

when you feel them (e.g., "I am not good enough, I am worthless," or "I
always fail") or have an emotion that rises inside of you (e.g., about yourself
being worthless). However, it may be that you have a lot more than these
automatic thoughts and emotions floating around inside of your brain.

c. You can work on changing these automatic thoughts by identifying the

meaning you have about yourself concerning things that have happened in
life, what bad things people have said about you (that are not true), and
how this has impacted you.

d. It is important to notice that your automatic thoughts may be associated

with feelings (e.g., "I am a bad person" or "I am worthless"); this is why you
are feeling the way you do (e.g., an emotion like sadness, anger, guilt,
shame). It is helpful to know that these feelings will pass and not stick
around forever. So, don't be too hard on yourself when you have negative
feelings about yourself, as it may not be true.

e. You can identify these automatic thoughts by reflecting on things you

have done in the past or your behavior now. What meaning do you give to
this behavior? (e.g., "I am a bad person for drinking alcohol when I know it
is not good for me"). Consider this meaning and think about the thoughts
you are having now. Concerning this meaning, what new meaning have you
come up with that may explain why these automatic thoughts occur?

f. Identify the emotions that come before your automatic thoughts (e.g., "If I
feel sad, I will drink alcohol."). This means being aware of your emotions
and how your beliefs may influence them about yourself (e.g., "If I feel
angry, I will drink more than usual."). This awareness will help you think
about what your automatic thoughts mean to you and how they influence
your behavior.

g. Being able to identify the thoughts that influence your feelings (e.g., "If I
feel sad, I will drink more than usual"). This is knowing that these thoughts
come from believing that you are a bad person, worthless, or stupid (these
are only some examples). It is important to realize that this does not make
sense concerning who you are and that it is not true (e.g., being a bad
person or worthless is not who you are).

h. You can start resetting your automatic thoughts by challenging them with
other thoughts. See if you can come up with some other thoughts that are
more accurate about you and how you interact with the world (e.g.,
thoughts like: "People don't think I am a bad person because I try my best, I
have been sad lately, I am a good person,"). It is important to take time to
think of what your new automatic thoughts are because your old ones may
not be true.

i. You can also question whether these unwanted beliefs are true. Repeating
these thoughts may mean false (e.g., "I am a bad person if I drink alcohol
even though it does not change anything").

Challenges and Difficulties with DBT

Many challenges and difficulties can arise when learning and implementing
DBT.

Here are just a few examples:

a. DBT can be challenging because it requires you to change your thoughts

about yourself and your life.

b. DBT can also be challenging because it is a very complex program of

treatment that takes time and practice to learn and master.

c. DBT takes time and practice to learn since it is not one lesson you can
learn immediately but a set of skills that need to be learned, practiced and
reinforced to work correctly.

d. All these skills need to be taught simultaneously so that they become

automatic and are always present in your mind whenever you are
experiencing an emotion or a thought associated with one of these thoughts
or feelings.

e. DBT takes time to learn. It is not something you can learn in a week or a
few days and then move on with your life, but it takes time.

f. There are also a lot of questions one should ask oneself to understand the
purpose of DBT (e.g., what is my purpose with life, why am I here, how do I
live my life meaningfully, etc.) This can lead to many difficult feelings later
when one is learning DBT and getting things wrong because they do not
understand the true meaning behind their thoughts.

g. All of these types of questions that you will be asking about yourself and
your life may lead to a lot of emotional pain and struggles.

h. DBT can also be challenging because it is quite difficult to accept the idea
that you, who are reading this book, sometimes have thoughts that are not
accurate about yourself or your life or may not be true (as opposed to the
automatic thoughts that you may have). This can involve changing the way
you think about and understand yourself and others concerning the world.

i. DBT can also be difficult because it involves accepting that there are
things that do not make sense inside of your brain. In addition, these
automatic thoughts influence your behavior which may lead to challenges in
managing your emotions, thoughts, and actions.

j. DBT can also be difficult because it requires you to do things differently

than you are used to. This will involve a lot of change for you to start
thinking about yourself differently and accept that some of these automatic
thoughts may not be true.

k. Since DBT is a complex problem-solving technique, it can get quite

confusing if you are not paying attention or grasping the concepts behind
what you are learning (e.g., why do I have these automatic thoughts which
influence my behavior?).
 Dialectical stance and strategies
Dialectical stance and strategies are a rare tool used to treat Borderline
Personality Disorder (BPD). Dialectical behavior therapy was developed in
the 1980s by Dr. Marsha Linehan. It is an evidence-based practice with
well-documented efficacy for BPD.

Dialectical Behavior Therapy, also known as DBT, is a type of psychotherapy

created in the 1980s by psychologist Marsha M. Linehan to help adults
diagnosed with borderline personality disorder (BPD). The purpose of the
creation of DBT was to allow those diagnosed with a borderline personality
disorder to be capable of living an independent and functional life.
However, symptoms of BPD were causing them significant distress and
impairing their ability to function in society. Therefore, DBT is a type of
behavior therapy known as "Dialectical Behavior Therapy" or DBT.

Dysfunction within self-concept, usually associated with identity

disturbance, can be viewed as contributing factors determining the
development and maintenance of behaviors controlling the individual's
external world. In addition, dysfunctional patterns may also form due to
other factors such as societal norms, personal history, and cultural
influences.

Dialectical Behavior Therapy is divided into four major components typically

implemented within a specific order during a course of treatment. The four
components of DBT include individual therapy, group skills training,
telephone consultation team, and psychoeducation to the patient's
significant others (family, friends) who may be involved in the individual's
treatment plan:

The fourth component of DBT involves psychoeducation for family members

and loved ones on how they can best support the patient in their recovery.
It is usually included at some point after the patient has been stabilized.

The goal of each component is to help the person effectively cope with their
emotions.

A major aspect of DBT is the "Dialectical Behavior Therapy Skills Training

Program." This program includes ten treatment modules that outline a
series of skills that an individual must master to better cope with their
symptoms and for the individual to be able to engage in everyday life.

Three initial modules instruct the individual on how to use their feelings,
thoughts, actions, and behaviors to better cope with challenges that may
arise in everyday life. There is also a more advanced module called
"Flexibility," where individuals practice flexibly using their thoughts and
actions as a form of self-regulation.

The individual therapy modules are designed to help individuals learn skills
that can be used to overcome their emotional dysregulation. The skill is
taught in a step-by-step fashion, which allows the individual to practice
before moving on to the next skill with the hope that they will master it to
help them function more effectively in their everyday life.

Currently, one module called "Acceptance and Commitment Therapy" has

received great success within DBT. It is used for patients who suffer from
emotional dysregulation and experience strong urges for intense emotions,
such as rage, anxiety, and depression.

As part of the Skills Training Program, an individual will practice the skills
they learned in an individual session with a trained therapist. The
individual's therapist then reviews this training. In one study, on average,
DBT therapists spent 17 hours per month with their clients.

Dysfunctional behaviors within self-concept can be viewed as contributing

factors determining the development and maintenance of behaviors
controlling an individual's external world. However, dysfunctional patterns
may form due to other factors such as societal norms, personal history, and
cultural influences.

What are dialectical stances?

Dialectical behavior therapy (DBT) is a form of psychotherapy that helps
individuals with a borderline personality disorder. DBT is based on the idea
that the person's personality has a split or two parts—that are usually in
conflict with each other. The goal of DBT therapy is to help individuals learn
how to manage their behavior and emotions to achieve a balance between
these two parts. A dialectical stance is an approach that helps to
understand and manage these conflicting forces within an individual.
Dialectical stances help individuals recognize and understand their
thoughts, feelings, and behaviors while simultaneously recognizing their
relationship with their environment.

Marsha Linehan developed DBT as a treatment for individuals with

borderline personality disorder (BPD). While the treatments for BPD are
still being researched, DBT is an effective way to help clients overcome
their symptoms.

Dialectical behavior therapy is based on the cognitive behavioral principle

that most people have two mindsets (dialectical stance) or two opposing
ways of thinking and feeling. These stances can be categorized as "more
than" or "less than." For example, one could take the stance that life is
generally good and enjoyable while simultaneously acknowledging that
some aspects of life are more negative than others. These conflicting
stances are referred to as dialectics because they frequently involve a
change from one position to its opposite.

Individuals with BPD are believed to feel extreme emotional experiences in

response to events around them or within themselves. This may lead them
to feel intense emotional highs and emotional lows simultaneously. For
example, an event could cause an individual with BPD to feel both happy
and sad simultaneously, or the individual might feel depressed and angry at
once. Research has found that individuals with BPD experience these
emotions more intensely than what is considered normal by most people.
Individuals with BPD may also struggle with controlling their impulses,
which can cause difficulty managing their behavior.

Dialectical behavior therapy (DBT) is a form of psychotherapy used to treat

BPD. DBT focuses on teaching individuals tools to help them cope with their
emotions and learn how to regulate their behavior better. To help
individuals with BPD learn these skills, therapists may assess clients'
cognitive processes, such as their views on themselves, others, and the
world. For example, therapists believe people with BPD see themselves as
worthless or sinful while thinking they are better than others. Individuals
with BPD may also think they are self-conscient or inherently have low self-
esteem. Therapy will help individuals learn how to gain more self-esteem
and develop healthier relationships. Therapists may also help individuals
learn the skills to manage their impulsiveness and emotional dysregulation
better. Improving these skills is expected to improve an individual's
emotional life and help them become more effective in their everyday lives.

Dialectical stances, therefore, provide many benefits. First, dialectics allows

individuals to acknowledge their internal and external worlds while
recognizing the relationship between these two parts. They also help
individuals who struggle with BPD recognize the difference in how they see
themselves and others.

Dialectical behavior therapy (DBT) is a type of therapy that focuses on

helping people who experience severe emotional dysregulation or suicidal
urges. Because of its focus on helping people learn skills to regulate their
emotions and behavior better, DBT is an effective treatment for people with
BPD. In addition, the skills learned in DBT can help individuals form better
relationships with others, make healthier decisions about their daily lives,
and improve their quality of life overall.

Self-concept is an individual's perception of themselves. Self-concept can be

divided into two categories, social self, and personal self. The social self is
based on how the individual views their identity concerning other people.
This can include their appearance, behavior, thoughts, and actions. The
personal self category focuses on individuals' conception of who they are by
themselves without being influenced by others. Self-esteem is the degree to
which a person views themselves positively or the degree to which they
value their abilities and traits (accomplishments). This is also referred to as
self-concept. Self-esteem can be measured through self-report measures
such as the Rosenberg Self-Esteem Scale and other measures of self-
concept, such as the Multidimensional Scale of Perceived Social Support.

A person's self-concept can vary based on many factors, but its relationship
with daily functioning is often linked. For example, people with high self-
esteem tend to show more confidence in themselves and their abilities,
allowing them to perform better socially and feel prouder. This can lead to
higher performance expectations for themselves, which leads to the more
frequent achievement of more desirable goals and positive experiences. On
the other hand, people with lower self-esteem can experience sadness and
unhappiness because they do not feel good about themselves. This can lead
them to seek out negative experiences to validate their negative beliefs
about themselves or avoid situations that may make them look bad to
others.

People with a higher self-concept sense tend to have healthier relationships

with others. They feel more comfortable with themselves and seek out
healthy relationships (both platonic and romantic) more often. They also
tend to be better at understanding the needs of others, which is likely
because they can identify with those needs in a way that people with low
self-concepts cannot.

Many people with borderline personality disorder (BPD) also experience low
self-concept. This can result from their tendencies towards negative
thinking, which makes it easy for them to focus on the negative aspects of
themselves and their lives. People with BPD may also have experienced
trauma or abuse during their childhood, which may affect their self-concept
in a way that makes them feel like they are not deserving of love and care
from others. Because BPD is associated with severe emotional
dysregulation, many people with BPD may have difficulty controlling their
emotions, thoughts, and actions, leading to negative social interactions that
can worsen their self-concept.

There are many methods of dealing with low self-esteem, including therapy.
Dialectical behavior therapy (DBT) focuses on teaching clients skills to help
them positively cope with their emotions, allowing them to foster healthier
relationships with others and themselves. DBT is based on the idea that an
individual has a strong internal self, fully capable of making decisions and
creating plans for their life, and an external self, which includes all of their
social interactions. Therapists hope to teach clients how to use the "real"
self (internal self) to better interact with others rather than falling into the
habit of using their external selves (based more on their emotions).

What are dialectical stances used for?

Dialectical stances help individuals with BPD recognize their internal and
external selves and how they are connected. They also help clients learn
how to regulate their emotions, thoughts, and behavior based on these two
parts. Dialectical stances are also used to help people with BPD develop
better relationships with others. Dialectical stances can also help people
with BPD improve their quality of life.

Dialectical stances are used in treating borderline personality disorder

(BPD). Dialectical behavior therapy (DBT) focuses on helping clients learn
to cope with their emotions and behaviors, which is BPD's main symptom.
This can be done through dialectical training, which involves understanding
the relationship between a person's internal and external selves. Dialectical
thinking can help clients form healthier relationships with themselves and
others.

Dialectical thinking also allows people who experience BPD to recognize

that they do not need to rely on others for validation because they can
validate themselves. They can also identify the thoughts and feelings they
are experiencing, which allows them to understand themselves and their
relationships with others. This can allow people to react more appropriately
in social situations and develop more healthy relationships with others.

Dialectical thinking is also used in the treatment of people with BPD. It

focuses on improving social skills, which is an important aspect of dealing
with BPD. Dialectical training teaches individuals about the interpersonal
relationship between internal and external selves (self-control) by teaching
them that their "real" selves have a positive impact on their "false" self
(social self). This allows individuals to recognize when they fall into
dysfunctional behaviors that lead to poor behaviors, thoughts, or emotions.

The dialectical theory was developed by psychologist and psychoanalyst

Wilhelm Reich (1897–1957). Reich realized that the full knowledge of
human biology and psychology needed to include consciousness and
unconsciousness, psychic and social factors, biological and social traits,
logic, and illogic psychological laws. Furthermore, he informed therapists
and patients that human beings are unique only in their ability to rationally
experience and express emotional states, not in their competency to
observe themselves.

Reich also believed that characterological development could not be

understood without considering social and environmental influences on the
individual's life and personal characterological makeup. He developed the
psychosocial dialectic, a psychodynamic approach that uses mental illness
to help explain systemic or societal conditions. The term "dialectical"
derives from the Greek διαλεκτική (dialektikē), meaning "related to
conversation or debate." The dialectical approach to psychotherapy services
that any combination of opposing forces necessary to promote health and
well-being

Reich used the concept of dialectics to explain how human beings can be
egotistical and altruistic, suicidal and productive, hostile and open in their
communication, or capable at times of contradictory behavior. In this view,
an individual can be torn between characterological traits based on
sensitivity or rigidity. By understanding how these opposites are linked,
individuals can recognize the underlying motivations for their behaviors and
actions. Reich believed that anyone who understands themselves would also
understand social dynamics better.

Therefore, the roles of dialectical stances include:

a. self-attunement: a person acknowledges their passive and active role in

social interactions.

b. self-regulation: a person is aware of their power to regulate the

relationship between their internal and external selves, allowing them to
understand the "true" self-better.

c. conflict resolution: a person can use dialectic processes to resolve

disagreements with others and maintain healthy social relationships
determined by other people in their environment.

d. altruism versus egotism: an individual recognizes that they can act

altruistically or egotistically at different points in time or under different
circumstances (i.e., emotional vs. adult).

e. change of self-concept: an individual understands that their personality

traits are not set in stone and the variables they can control change
throughout their life.
f. cultural diversity: an individual can recognize that many different cultures
are based in different parts of the world, causing them to be more tolerant
and accepting of other people's lifestyles.

g. interdependence: an individual recognizes that they are inherently

interdependent with others and can adopt a sense of altruism without being
too dependent on others or having too much ego (i.e., dependency vs.
independent).

h. personal change: throughout their life, an individual recognizes that they

are capable of developing different personalities, which gives them more
options in their social interactions, relationships, and development.

i. opposites are not mutually exclusive: an individual will find examples in

the world where any given opposite is present at once (e.g., passion and
coolness or illness and health). They acknowledge that there is no such
thing as a mutually exclusive opposite. Individuals can recognize that they
are capable of both simultaneously and will depend on how they perceive
themselves (i.e., self-attunement).

j. change in perception: an individual recognizes that change happens over

time and that there are different stages to maturity (i.e., child, adolescent,
adult).

k. awareness of mind/body connection: a person understands that their

health is intrinsically linked to their emotional health and vice versa (i.e.,
emotional and physical health). An individual understands the relationship
between mind and body regarding emotional and physical issues such as
illness or pain.

l. awareness of social, cultural, and environmental influences: an individual

can recognize that their upbringing, the people in their lives, and the
environment can influence them (i.e., self-regulation).

m. knowledge and understanding of various cultures: an individual

understands various cultures based on where they are from, who they spend
time with or where they come from in general.

n. awareness of the external world: a person recognizes that certain things

affect them emotionally and physically (i.e., physical health).
o. awareness of others' thoughts and perceptions: a person can recognize
the thoughts and perceptions others have about themselves and their
reactions to those thoughts or perceptions (i.e., conflict resolution).

p. awareness of the moods of others: an individual can recognize how they

feel and what other people are feeling based on various situations. They
understand how emotions can be contagious (i.e., interdependence).

q. awareness of others' intentions: a person recognizes underlying motives

and their effects on their thoughts and perceptions about others (i.e.,
altruism versus egotism).

r. appreciation for differences: an individual acknowledges that different

people or cultures have varying opinions about issues, beliefs, lifestyles, or
values (i.e., cultural diversity).

Challenges and disadvantages of dialectical stances

Reich believed that the challenges or disadvantages of dialectical stances

include:

a. self-evaluation: an individual can become indecisive, non-resolved, or lose

faith in their decision and what they believe to be true (i.e., self-attunement
vs. rigidity).

b. changing environment: a person may not be aware of the changes that

are occurring around them and how their thoughts, perceptions, and moods
are being influenced by those changes (i.e., altruism vs. egotism).

c. cultural diversity: an individual may become overwhelmed by all of the

influences from other cultures and may start to conform to whichever
culture is most similar to their own (i.e., cultural diversity).

d. failure to understand others' beliefs: an individual may fail to understand

the motives or perceptions of others and make assumptions without fully
understanding that person or culture (i.e., self-regulation vs. rigidity).

e. unrealistic expectations: an individual can expect others to act a certain

way based on their self-perception rather than recognizing other factors
involved (i.e., conflict resolution vs. rigidity).
f. limited awareness of one's personality: an individual may not be able to
establish themselves as a separate and different person from the last person
they were due to their inability to recognize the differences between
themselves and those close to them (i.e., self-attunement vs. rigidity).

g. self-esteem issues: an individual's view of themselves may be lower than

how they are and can be developed to meet their needs at the expense of
others (i.e., self-esteem issues vs. self-service).

h. failure to recognize and adapt to change: an individual may not recognize

the changes around them, which can cause them to become more rigid or
indecisive (i.e., rigidity vs. change).

i. failure in perception: an individual may not clearly understand one's

previous perceptions or changes in their current personality, which can lead
to frustration and struggles in life (i.e., rigidity vs. flexibility).

j. failure to understand their strengths: an individual may not be able to

recognize their strengths and weaknesses, which can lead to problems in
relationships or understanding of one's goals in life (i.e., rigidity vs.
flexibility).

Dialectical strategies
Reich defined these dialectical strategies:

1. Double-Sided Dialectical Strategies: This requires individuals to

recognize their strengths and weaknesses and how others perceive them
(i.e., sensitivity).

2. Dialectical Self-Regulation Strategies: a strategy that requires an

individual to understand their current situation as well as their previous
perceptions, moods, thoughts, or feelings to make appropriate decisions or
avoid impulsive decisions (i.e., regulating).

3. Dialectical Awareness of Self Strategies: a strategy that requires

individuals to recognize their self-perceptions, moods, thoughts, or feelings
with others' perceptions of them (i.e., self-equalization).

4. Dialectical Accommodation Strategies: a strategy that requires an

individual to recognize their strengths, weaknesses, and perceptions of
other people to properly understand how each of them can be beneficial or
hurtful to the relationship (i.e., altruism).

5. Dialectical Integration Strategies: a strategy that requires an individual

to have an awareness of their strengths, weaknesses, and perceptions to
acknowledge the impact on themselves and other people as well as how
they can be beneficial or hurtful (i.e., understanding).

6. Dialectical Consciousness-Raising Strategies: a strategy that requires an

individual to acknowledge the presence of other people and how their
actions, perceptions, moods, thoughts, or feelings can be beneficial or
hurtful for themselves and others (i.e., awareness of others).

Reich believed that the above strategies are not created by one's specific
beliefs or behavior but result from life experiences. Those experiences can
be changed to improve dialectical stances. For example, suppose an
individual believes that people should always be accepting of everything. In
that case, they will have difficulty in their relationships if they do not
understand the differences between certain actions and emotions. They can
then change their stance to understand better how people's moods or
thoughts affect themselves and others.

Reich believed that dialectics could be used to understand what is

happening inside people, such as their personalities or behaviors. He
believed that this knowledge could help individuals better understand how
their behavior affects others, allowing them to understand better other
behavior and how they affect them. In this way, the individual can see their
personality traits as something that is learned, not innate.

Reich believed that dialectics was a concept that could help people learn to
act more effectively at work or deal with the problems they face at home or
in relationships. He also believed that dialectics could be used to make
decisions and problem-solve at work or change aspects of one's life to
become happier.

Reich believed that dialectics is a "triadic philosophy of life" because it

provided an understanding of life that was different from traditional
Western philosophies. This is due to dialectics' ability to see the relationship
between different influences, such as interpersonal and intra-psychic
relationships. These two types of influences are referred to as "abstract
ideas" since they are seen more than experienced and are not completely
understood in their true forms.

Reich's belief about how individuals learn about their characteristics, such
as gender or age, was similar to Freud's notion about how the mind and
behavior were related. Reich's belief about how their surroundings and
interactions with others influence individuals was similar to Gestalt therapy.

Reich believed that using dialectics could help individuals deal with people,
such as coworkers or family members, who were critical of them. He
believed that these people are not always critical of the individual. Instead,
they may be being critical of the individual's situation or where they are in
life. The person may not understand why they have these attitudes and
behaviors, which can lead to an individual becoming angry or frustrated
when dealing with them.

These strategies can be developed through mindfulness, which is engrained

into the dialectical approach. Mindfulness is a process that involves being
aware of one's internal and external environment. Moreover, it involves
being attuned to the events that are currently taking place and being aware
of how these events affect oneself and others. Mindfulness is said to allow
an individual to be completely attentive to one's surroundings to understand
better the relationship between their behaviors, thoughts, emotions, and
other people.

Furthermore, mindfulness also involves having a non-judgmental attitude

about the environment or current situation one is in. By not judging their
surroundings or current situation, individuals can see it for what it is and
not attach their emotions and thoughts to it. This allows them to objectively
assess situations while remaining true to themselves and their feelings
throughout any given situation. This can help them have less anxiety when
dealing with critical people around them.

Disadvantages and challenges of dialectical strategies

Dialectical strategies can be an advantage for certain individuals to

enhance their relationships and communication. Both professionals and
laypersons can use them to achieve better outcomes that benefit themselves
and others.

For the dialectic approach to work, the individual must have a "cooperative
attitude." This means they must understand the concepts of their
environment or situation being analyzed, accept it as an indivisible whole,
and not try to change it by changing one variable in isolation.

The dialectic approach also requires a person to have adequate self-esteem,

which is "the capacity of one's belief system, feelings, attitudes and
behavior to cope effectively with environmental pressure." Moreover, their
self-esteem should also be strong enough to allow them to be objective
about themselves and their surroundings.

A person's approach to learning, the way they accept information, and what
they believe in will determine whether the dialectic approach will benefit
them or not. It also matters how receptive a person is to different views and
opinions and if they are open-minded enough to understand and accept
other ideas that do not follow along with popular views.

Reich's theory was developed from psychoanalytic theory by focusing on

social issues to "rehabilitate character," which is comparable to the aims of
other psychotherapists like Alfred Adler, who also were concerned with
social problems.

Reich developed his character analysis theory from Freud's psychosexual

development theory. This is why there are similarities between Freud's
stages of sexual development (oral, anal, phallic, latency, and genital) and
the different stages a person goes through during the character analysis
process. Both are used to develop one's personality. However, Reich viewed
the psychosexual stages as something a person goes through only once
during childhood. In contrast, the character analysis process is something
that a person can go through multiple times throughout their lives to
understand better how they interact with others.
 DBT strategies for an individual session
DBT strategies for individual sessions can be used to address three different
goals for individuals: mindfulness, emotional regulation, and interpersonal
effectiveness. DBT strategies can be adapted to relieve any individual's
problems. For example, a therapist might adapt DBT strategies for use with
a person who engages in self-harm to reduce their need or urge to self-
harm. Strategies that facilitate emotional regulation in an individual session
might help them feel better within themselves after an episode of violence
or harm. Finally, an individual session can focus on interpersonal
effectiveness by teaching the person ways to avoid or reduce feelings that
can lead to harmful behavior. In addition, the therapist might teach the
person how to release pent-up anger and frustration "in a safe way."

Overall, the DBT model consists of three modules: The first is individual
sessions, in which the therapist may focus on mindfulness, emotional
regulation, and interpersonal effectiveness. The second module is group
sessions, in which the therapist may focus on relapse prevention. The third
module is phone calls to a therapist who specializes in DBT and can offer
support and guidance. If a person fails to engage with basic modules after
three weeks of therapy at a level one clinician would consider satisfactory;
they will be referred to a more experienced clinician who conducts
specialized training to treat those issues such as suicidal behaviors or
severe reactions.

DBT is typically structured around more frequent core-skills group sessions

with weekly individual 1-hour sessions and a support group. DBT uses four
main strategies to address behaviors: situation-, emotion-, cognition-, and
action-oriented. When a person has a behavior that disturbs them in some
way, they bring it up at the next meeting of their therapy team. The team
can then discuss how they will handle the situation based on different
strategies. First, the emotion-oriented strategy involves choosing a
nonjudgmental attitude by accepting one’s emotions as one presents
themselves without attempting to change them. Secondly, the situation-
oriented strategy involves identifying the functional benefit of behavior for
the person until they can achieve alternative ways to achieve that function,
such as through DBT skills training. Thirdly, the action-oriented strategy
involves choosing a behavior to replace the problem and learning to engage
in that new behavior. Fourthly, the cognition-oriented strategy involves
identifying how a person’s distress interferes with their ability to think
clearly and subsequently interferes with their ability to choose effective
behaviors, leading them into more distressing situations.

Within each session, four main skills are worked on. The first of these skills
is distress tolerance, which addresses a person’s inability to tolerate high
levels of emotional distress. The second is emotion regulation, which
focuses on how a person can better control their emotions; this skill is used
for distressing emotions that are hard to tolerate and for intense positive
emotions. Thirdly, interpersonal effectiveness refers to developing
relationships with others to improve the lives of the individual and those
around them. Lastly, mindfulness refers to helping those who are depressed
deal with negative thoughts without acting on them rather than reacting in
response to these thoughts.

The focus in DBT therapy sessions is on "skill-building" so that clients can

learn skills they will use between sessions. The skills that a therapist works
on with an individual either in an individual session or during skill-building
groups typically include the following:

There are four modules of DBT. The following outlines the typical approach
to each module and an example exercise. Module 1 is structured around
weekly one-hour sessions and includes skills training. Module 2, which
takes place once a week, involves a more structured format than Module 1
and focuses on relapse prevention. In Modules 3 and 4, which occur once
every other week, there is a focus on telephone consultations between
sessions that can be done as needed or for help with recovery after self-
harm and when individuals are considering suicide. Each DBT meeting
consists of four major objectives. The first objective is to establish a
foundation for the therapist and client. The second is to assess and modify
any problems that the client may have. The third objective is to increase
skills training session by session. A fourth objective is to create situations
where clients can make errors with minimal negative consequences and
learn from them.
The therapist will assess the person’s problem behavior (e.g., depression,
suicide) and then work on building up their ability to deal with distressing
thoughts and any emotional struggles with both physical skills training in
DBT and emotionally based therapy (EBT). The therapist will also assess the
person’s strengths and weaknesses and work with them on areas they are
weaker in to help improve their quality of life. The therapist will also
identify what type of attitude the person has towards other people and the
person’s general way of thinking to develop a better sense of how they
relate to others.

The typical format for Module 1 includes three major parts, which are called
"core-skills groups," "individual therapy," and "phone consults." Each part
will be discussed in more detail below.

When working with clients in Module 1, there are 15 skills divided into four
categories: distress tolerance, emotion regulation skills, interpersonal
effectiveness skills, and mindfulness. Distress tolerance skills involve the
person learning how to deal with their emotional struggles by gaining
greater self-awareness and control of their emotions. Emotion regulation
skills teach them to better deal with distressing thoughts by better
identifying the connection between these thoughts and the emotions that
occur as a result. Finally, interpersonal effectiveness skills focus on
improving the communication between clients and their therapists. In
contrast, mindfulness focuses on developing the individual’s ability to think
clearly and respond to negative thoughts instead of acting on them. In
addition, two exercises are used during Module 1:

DBT strategies that facilitate mindfulness:

One of the Dialectical Behavior Therapy (DBT) goals is mindfulness, "which

refers to an alert and nonjudgmental present-focused awareness."

The client is taught three skills: (1) observing with curiosity, (2) describing
with equanimity, and (3) participating in activities mindfully. These skills
help with regulating emotions both during and after triggering situations.

Mindfulness Skills in Individual Sessions: The focus of the present module

will be on these mindfulness skills.
Observing with curiosity refers to staying in touch with the present moment
and observing one's sensations and feelings without judgment.

Equanimity means letting go of judgments about one's feelings and just

describing them with words.

Participating in activities mindfully refers to the daily activity as if it were

being done for the first time, noticing every detail: sights, sounds, smells,
tastes, and physical sensations. This skill may require a therapist to help
refocus clients who get off track by judging their experience or comparing it
with that of others.

Therefore, the DBT strategies for individual sessions include:

1. Observing with curiosity:

The present module teaches clients to stay present and maintain an active,
inquisitive mind by using exercises. The skills required in this exercise
include as follows:

Observing with curiosity in a way that helps clients realize they can be
aware of what they are observing without judging it as good or bad.

Identifying the activities that cause suffering.

Mentally noting that when emotions arise, these feelings happen because
something triggers them.

Recognizing these responses is not the same as wanting to change the

situation or receiving comfort from others.

Learning how to be mindful of the sensations that come from within.

Remember that it may take time for them to understand these mindfulness
skills and incorporate them into their daily lives.

The therapist should ask if they understand these skills and explain that
they must practice applying them to improve their skills further. Challenges
can occur when the individual believes they already have this skill or do not
use it effectively. Therefore, the therapist needs to help refocus them on
their goal of learning and practicing this skill. The therapist can also help
identify triggers for emotional responses or a lack of mindfulness in daily
situations so that clients can work on these areas.

2. Describing with equanimity:

The present module aims to teach clients to describe a difficult situation or

experience without judgment. The skills required in this exercise include as
follows:

Describing with equanimity in a way that helps clients notice their feelings
and sensations with equanimity.

Identifying what they need and what they don’t need, in an objective way,
instead of reacting.

Knowing that expressing something can solve a problem rather than create
new ones. Using “I” statements and describing the situation from their
perspective is not based on what other people think or should say. Exercises
consist of deep breathing exercises, meditation, and guided imagery.

3. Participating in activities mindfully:

The present module aims to teach clients to participate in daily activities

with a new level of awareness. The skills required in this exercise include as
follows:

Participating in activities mindfully by remaining present with everything

they experience.

Identifying their feelings and sensations at that moment.

Including the feelings and sensations as part of their observations rather

than ignoring or judging them. Exercises include walking, deep breathing,
guided visualization, and mindfulness meditation.

4. Mindfulness exercises for daily living:

The present module aims to teach clients how to remain mindful during
everyday activities that may evoke emotional responses or thoughts. The
skills required in this exercise include as follows:

Resting the mind by practicing deep breathing, guided imagery, or

mindfulness meditation for a short breather.
Reminding themselves to focus on their core values, especially those that
help them manage their emotions and impulses, such as self-respect and
other-respect.

Mindfully engage in a daily activity by practicing one of the above

mindfulness skills.

Exercises include yoga, physical activities, and daily tasks like eating and
bathing. In addition, they focus on observing without judging one’s
experiences while practicing self-care by taking time to heal. This can take
time to accomplish because clients have spent years experiencing emotions
and thoughts that have been unhealthy for them.

5. Behavioral exercises for daily living:

The present module aims to teach clients how to incorporate mindfulness

into their daily activities and address barriers as they arise. The skills
required in this exercise include as follows:

Identifying and addressing obstacles that may hinder their progress daily.
In addition, they should use mindfulness skills, such as breathing exercises,
meditation, and guided visualization.

Modifying behaviors or thought patterns can lead to emotional

dysregulation or behavioral dyscontrol. They should allow themselves to
experience their emotions without acting on them, even if it might be
difficult for them. They should allow themselves to accept and explore their
emotions while caring for their needs. Exercises consist of using Neuro-
Linguistic Programming (NLP).

6. Interpersonal exercises for daily living:

The present module aims to teach clients how to remain mindful in social
interactions and address barriers as they arise. The skills required in this
exercise include as follows:

Modifying behaviors or thought patterns can lead to emotional

dysregulation or behavioral dyscontrol. They should allow themselves to
experience their emotions without acting on them, even if it might be
difficult for them. Instead, they should allow themselves to accept and
explore their emotions while caring for their needs.
Identifying unhelpful behaviors and how it makes other people feel. They
should take responsibility for their behaviors and apologize, even if they
cannot explain them. Often, this is the first step toward recovery for the
individual because it helps create a more calm atmosphere in their
relationships with others. Exercises consist of practicing NLP and educating
clients on interpersonal skills.

7. The role of mindfulness in recovery and life:

The present module aims to teach clients how mindfulness plays an

important role in their recovery.

They understand that they cannot return to old habits or patterns but must
find a new way of living daily. This includes habits related to thoughts,
emotions, and behaviors.

Understanding what mindfulness is and how it can be incorporated into

their lives. They should continue practicing the skills they have learned
throughout treatment to maintain their recovery from emotional
dysregulation or behavioral dyscontrol.

The therapist will be able to find ways that fit the client’s personality, goals,
and style, as well as techniques that best suit them. The therapist will also
be able to match the skills needed with what they can use to help their
clients. Therefore, the therapist needs to assess their clients and then help
them identify any personal characteristics they may have that would make
certain skills more effective for these individuals. These characteristics
include values such as respect or self-respect or learning styles like visual,
auditory, or kinesthetic.

8. Discovery and formulation of a plan:

The present module aims to teach clients how to share their recovery plan
with others and examine it regularly.

They know they must maintain recovery by staying present in their daily
lives. They should continue practicing the skills they have learned
throughout treatment to maintain their recovery from emotional
dysregulation or behavioral dyscontrol.

9. Ongoing support:
The present module aims to teach clients how to maintain a lifestyle of
mindfulness and how it is still necessary throughout recovery from
emotional dysregulation or behavioral dyscontrol. They should continue
practicing the skills they have learned throughout treatment to maintain
their recovery from emotional dysregulation or behavioral dyscontrol.

This means they can seek relapse prevention techniques, such as setting
boundaries, to avoid and repair unhealthy habits. They should also follow
the structure or process that their treatment plan outlines and realize that it
can take time for them to succeed in this way of living. Their therapist may
ask questions about their daily behaviors progressing and guide them if
necessary.

10. Life skills:

The present module aims to teach clients how to live a mindful life in every
aspect of their lives, including relationships, self-care, work performance,
and community involvement. In addition, they should continue practicing
the skills they have learned throughout treatment to maintain their recovery
from emotional dysregulation or behavioral dyscontrol.

These skills may include using relapse prevention techniques, assessing

triggers, and recognizing when one is sliding back into old habits. They may
also report trigger activities and engage in coping mechanisms that help
them deal with emotions.

The mindfulness-based cognitive therapy program manual helps to

understand the different and most effective strategies for treating
individuals who suffer from emotional dysregulation or behavioral
dyscontrol. Mindfulness-based cognitive therapy allows the individual to let
go of distressful feelings that are often overwhelming by being self-aware.

Characteristics of DBT strategies

Mainstays in DBT include emotion regulation, social skills training,
mindfulness, and interpersonal effectiveness (IPE). Although these
components are common to several similar programs, they are particularly
useful in DBT. Research supports the effectiveness of DBT for people with
BPD. Findings suggest that people with BPD who participate in DBT may
experience greater improvement than those who receive other types of
treatment for their illness. One study examined the impact of DBT on
patients with BPD and found significant improvements in interpersonal
skills and psychotic symptoms over a 6-month follow-up period.

The main characteristics of DBT are as follows:

a. Emotion regulation skills: DBT for BPD seeks to improve emotional

dysregulation and the relationship with the self by learning to identify
aspects of emotions and thoughts. The therapist will teach clients to control
their emotions by learning new techniques. These include mindfulness,
emotion regulation, and ethical leadership.

b. Social skills: The therapist will use many different protocols, from social
skills training, interpersonal problem-solving approaches, and cognitive-
behavioral therapy (CBT) strategies. DBT for BPD embraces these methods
but will also integrate other methods like dialectical behavior therapy (DBT)
and motivational interviewing based on empirical research.

c. Mindfulness: Mindfulness, a popular new therapy method, is widely used

in DBT. This technique is based on the mental perception that everything
can be known. The therapist will use this technique to teach clients how to
live in the present moment and understand their thoughts, feelings, and
behaviors.

d. IPE: The improvement throughout treatment will eventually lead to

recovery. The patient will learn how to relate to others as a person and not
just with a diagnosis or illness. This way, they can utilize self-reflection,
interpersonal effectiveness, and emotional intelligence (EI) skills. As
explained in RFT tools, they can learn new ways of expressing themselves
instead of using language as a weapon against others or themselves.

e. Problem solving: Clients will learn how to identify problems in their life
and how they can find solutions to these problems. Strategies can also be
used that help people work on their issues. Although members of the
treatment team will assist with problem-solving, they are not therapists.
f. Negotiation and mediation skills: These skills are employed to solve
disputes between others who may not be able to resolve their differences
without intervention. Skills taught in these areas include the following:

g. Life review: Clients will begin to develop a sense of peace and find an
inner sense of strength with the tool of life review.

h. Group therapy: As the patient’s skills improve, they will be able to

participate in group therapy. The therapist will help them use DBT skills
such as dialectical behavior therapy (DBT) and cognitive behavioral therapy
(CBT) in a group setting.

i. Medications: The team will continue familiarizing themselves with the

therapist’s medications. The patient’s family, friends, or caregivers may also
take these drugs during this period of intensive treatment as prescribed by
their doctor.

j. Learning disabilities: People with mild or moderate learning disabilities or

chronic BPD may need specialized assistance with social skills and cognitive
restructuring to complete treatment.

k. Self-injury: One of the most difficult problems in BPD patients is self-

injury. The patients may experience a sense of self-hatred and try to hurt
themselves on their own or even at the hands of others.

m. Suicidal behavior: Another acute problem people with BPD can

experience is suicidal behavior. Sometimes, a patient will present with a
dangerous suicide attempt after completing treatment, as described above.
In this case, ongoing treatment and support are imperative until this acute
situation is resolved, as described in RFT tools.

n. Alcohol and drug use: People with BPD, who are of legal age, may be
permitted to use alcohol or drugs according to their treatment plan. The
therapist will monitor and supervise the patient’s use whenever possible.

o. Relapse prevention: This is an important skill for the client who

completes DBT for BPD. If these people stay in contact with their therapists
and family, they are less likely to return to the previous unhealthy behaviors
that brought them into treatment.
p. Recovering from bullying, violence, and abuse: These issues can be
resolved by completing DBT for BPD treatment programs as described
above with RFT tools as needed.

DBT for BPD is a revolutionary new way of treating BPD patients. Including
old and new methods has created a whole new treatment incorporating
many strategies for dealing with mental health problems. This treatment
provides an ideal way for people suffering from BPD to manage their
emotions healthily, strengthen relationships with others, and become better
versions of themselves through self-evaluation, insight, and skill
development.

Preparing for a DBT session

This process is different depending on the individual therapist. For example,

some therapists may begin the meeting with a required script, and others
will begin with a consultation. They may also ask for specific problems to be
discussed in a session.

DBT therapists will often ask the client what they feel their goal is from
therapy and how they think therapy can best help them reach that goal. The
therapist may then frame it, asking how therapy can be used to address all
elements of this goal in some manner; for example, using DBT skills to
address self-injury or using DBT to address anger (your goals could be
expressed as “I want to stop abusing myself” or “I want my anger to go
away”). The therapist may then frame the discussion based on the client’s
answers by asking questions to help clarify why this is a problem for them
(e.g., "how does self-injury make you feel?").

The therapist will then consider how this behavior affects other people in
their lives and may ask what role other people play in perpetuating or
encouraging the problem (e.g., whether there are thoughts or behaviors of
others that serve to reinforce or maintain the difficulty). The therapist will
also ask about things that help and support change in this area of life, as
well as opposing points of view (e.g., what do they like about
self-injury/anger?).

DBT therapists will consider the client's specific problems and treatment
goals when preparing for these sessions. Some common goals may be:
• To become more aware of and manage emotions

• To build healthy relationships with others

• To establish a sense of self and identity

• To learn new skills to deal with life challenges.

These topics can be the focus of DBT sessions in combination with each
other where appropriate.

A typical DBT session includes the following:

• Opening statements and general questions discussed with the client

before beginning.

• A report on progress, including thoughts, feelings, behaviors, and

relationships.

• Discussion of problems identified during the initial therapy session.

• Self-help materials based upon the client's goals are presented (e.g.,
coping skills, anger management skills).

• Behavioral experiments are discussed and planned.

• Implementation of behavioral experiments, including assignments given

for homework to be completed between sessions.

DBT is intended to address the problems people experience through self-

injury and other behaviors they consider unhealthy. However, therapy can
help people identify the patterns of self-harm that lead to their problems
and then form new, healthier habits to live.

Self-injury is a common problem for BPD patients. People with BPD may
abuse drugs or have a compulsion to harm themselves at times of particular
stress or unhappiness. They also may appear difficult to care for as they
often have meltdowns that require medical attention and can leave family
members and caregivers feeling frustrated, angry, or upset by the behavior
of their loved ones.

Strategies for individual sessions include positive reinforcement in addition

to RFT tools and skills. Therapy can also include discussing a similar
problem that occurred in the past and using that experience as a teaching
moment to help the client become more aware of their emotions and
thoughts.

There are many healthy things that people with BPD can do in their lives.
These include attending CBT, DBT, mindfulness, and relaxation therapy
sessions and taking medication only as prescribed by a doctor. However,
the tools for action and motivation to achieve healthy behaviors typically
come from practicing the skills of change in DBT.

Key Points for Individuals

Important points for individuals who are undergoing DBT treatment include:

• Accepting that they have a problem with self-injury and abusive behaviors
is an important part of recovery.

• Learning how to identify these behaviors or thoughts that lead to the need
to harm themselves is essential to recovery.

• Working with a professional therapist who can help them identify the
patterns in their thoughts, emotions, and behaviors that lead to harmful
behavior is essential.

• Learning how to use cognitive behavioral therapy and mindfulness skills

to cope with stress or incidents of self-injury are also essential.

• It is important to practice new healthy ways of handling situations that

make them feel stressed or upset (e.g., take a walk).

• There will be times when people have urges for self-injury and abusive
behaviors but can resist these urges before acting on them. This is just part
of being human.

After a DBT session

It is important to note that in some cases of self-injury, the person

experiencing urges may be unable to control their behavior. Therefore, it is
important that therapy can also include a plan for learning different ways to
get through certain problems. For example, people who have experienced
self-injury or abusive behaviors may start taking medications prescribed by
their doctor or therapist during DBT treatment. In addition, people may also
begin medication for psychiatric disorders after undergoing DBT treatment
(e.g., Xanax for panic attacks).

Many people who have experienced severe symptoms of BPD experience

episodes of improvement and progress through therapy over months or
years. During their time in therapy, clients can learn skills and strategies to
help them with relationships, self-harm and abusive behaviors, emotions,
and anxiety.

DBT treatment tends to be long-term in nature. The average length of

treatment for BPD is about one year.

Although DBT was originally developed as a treatment for people diagnosed

with borderline personality disorder (BPD), there is growing evidence that it
can be effective for many disorders, including schizophrenia spectrum
disorders, depression, bipolar disorder, and bulimia nervosa.

People with BPD are at an increased risk of developing mood-disordered

psychotic symptoms, such as hallucinations and delusions, particularly
during periods of high stress and low self-esteem. However, studies have
shown that combining cognitive behavioral therapy (CBT) and medication
may significantly reduce the number of mood-disorder psychotic symptoms
experienced by individuals with BPD.

There is controversy over using CBT alone as a treatment for borderline

personality disorder. In one study, many people who had previously been
diagnosed with BPD did not respond to CBT alone and were not able to
stabilize their emotions. CBT was also ineffective for treating some other
psychiatric conditions experienced by clients with BPD (e.g., depression).
 How to use DBT to overcome main
psychological problems
Dialectical Behavior Therapy (DBT) may be the solution if you struggle with
a psychological issue.

DBT is an effective treatment strategy that can help people with various
mental health problems, including depression, anxiety, addiction, eating
disorders, and self-harm. It aims to manage these problems and improve
one's quality of life by teaching mindfulness and emotional regulation skills.

The problem begins when one fails to manage their emotions appropriately
in response to specific situations or events that trigger negative feelings.
For example, if someone has an eating disorder triggered by food-related
triggers or someone engages in self-harm due to past trauma, they may
engage in compulsive behaviors such as cutting their skin without even
realizing it. This happens because they cannot regulate their emotions.

Dealing with negative emotions using DBT involves four steps:

1. Identify the emotion(s) you are experiencing at the moment

2. Accept and acknowledge these feelings, noting them without judgment or

thoughts of how to change them

3. Choose a healthy behavior to help you become less caught up in your

emotions. This might include exercise, talking to a friend, meditating, or
going for a walk

4. Repeat this process two more times throughout the day

To achieve healthy behavior change through DBT, specific skills, such as

distress tolerance and mindfulness, must be used. Distress tolerance is the
ability to cope with the physical and emotional effects of strong negative
emotions. Mindfulness skills are ways of keeping yourself in the present
moment without judging your current experience. The DBT therapist
teaches these skills in a structured cognitive-behavioral treatment plan that
combines individual, group, and telephone therapy sessions.

DBT was created as a treatment for Borderline Personality Disorder;

however, it has since been modified to help with other psychological
problems. It is used by psychiatrists, psychologists, social workers, and
therapists who treat people struggling with anxiety, depression, and self-
harm problems.

The most common treatment combines individual, group, and telephone

therapy. This provides opportunities for the patient to practice new skills
with the DBT therapist in an individual session and socialize with other
patients in a group session. In addition, in telephone therapy, patient can
call their therapist whenever they want to talk about something relevant to
their problems.

In some cases, these three levels are unnecessary, and a combination of

individual therapy, self-help materials, and weekly skills training groups
may be sufficient.

Individual therapy sessions consist of a one-on-one meeting with the

therapist at least once a week, usually lasting for an hour or more. The DBT
therapist guides the patient in learning new skills for dealing with their
emotions to achieve balanced and healthy behavior change.

Group therapy sessions are conducted in a very structured way, allowing

the patients to work on the same skill step by step. For example, the group
may work on reducing social anxiety by going out in public places.
Previously, they avoided such places for fear of being judged or criticized.

Therefore, DBT can be used to overcome main psychological problems

through:

a. Adopting a healthy lifestyle and feeling better with the right skills to help
manage one's own emotions

b. Adopting a healthier, more physically active diet by learning to tolerate

strong emotions and not engage in unhealthy behaviors

c. Learning to recognize and accept feelings without criticizing or acting on

them

d. Taking more responsibility for one's life and looking after oneself without
engaging in compulsive habits, such as self-harming or engaging in risky,
impulsive behaviors that may lead to addiction
e. Avoiding reinforcing negative thoughts such as "I am not good enough,"
by avoiding any criticism or negativity in one's life, which can lead to self-
judgment or shame

f. Maintaining a healthy social life by finding hobbies, making new friends,

and developing the necessary skills to achieve and maintain long-lasting
relationships

g. healthily dealing with negative emotions before they lead to addiction or

other serious, harmful behaviors such as self-harm or eating disorders

h. Maintaining a proper diet while feeling better about one's body by

learning to treat oneself with respect and love

Managing strong emotions is difficult; however, with the support and

structured treatment offered through DBT, one can learn to manage their
emotions in healthy ways. DBT is a comprehensive treatment strategy
involving many different therapy sessions.

For example, through mindfulness exercises, one learns to be aware of their

thoughts and feelings without judging them or engaging in compulsive
behaviors. In individual therapy, the therapist encourages patients to look
at their destructive behavior and develop new skills to deal with difficult
situations.

By practicing these new skills, patients can find healthier ways to handle
strong emotions and addictive behaviors while living a more balanced life.
Therefore, DBT can help overcome most psychological problems through
adopting a healthier lifestyle and learning to cope with one's negative
emotions in positive ways that are not harmful to oneself or others.

How to use the skills

DBT skills can be used in all kinds of situations. Some skills help deal with a
specific situation, while some are general properties that can be used
repeatedly regardless of the situation. Skills are also used through different
mediums. For example, skills can be practiced in therapy and used in real-
life situations. Skills can also be practiced through self-help material or
journaling.
Three primary skills are used in DBT, and each can help deal with specific
situations. These three skills are Mindfulness, Distress Tolerance, and
Emotion Regulation.

Mindfulness is “learning to observe your thoughts, emotions, and

experience, non-judgmentally” (Linehan). Through mindfulness, people can
recognize their thoughts for what they are and not act on them. It is also a
great example of acceptance because through mindfulness, one accepts the
way things are rather than trying to change them or make them different
from how it is. DBT patients can practice several types of mindfulness
exercises to practice mindfulness. Mindfulness can be used for all aspects of
life, so it is an important skill to have.

Distress Tolerance is a skill that helps the patient confront their feelings
and not give in to them. It also involves the patient learning to accept and
tolerate strong emotions without engaging in compulsive behaviors such as
self-harm or eating disorders. In addition, this skill can help a person
empathize with different feelings and learn how to respond appropriately in
different situations.

Emotion Regulation is a skill that helps the patient learn how to deal with
their emotions in healthy ways. It also involves the ability to reflect on one's
behavior when dealing with emotions and to take responsibility for one's
actions. The main idea is not to let emotions control your behavior but to
take control of your negative emotions. For example, suppose someone is
angry instead of physically lashing out at someone or through smart
remarks. In that case, the person should be responsible and find a better
way to express their anger, such as punching a pillow or talking to
themselves about their feelings.

Dialectical Behavior Therapy Skills can be practiced in group settings,

individual therapy sessions, and in self-help material.

Therefore, these DBT skills can be implemented through:

a. Group (supportive) therapy

This is a good way to practice DBT skills because the other group members
can help support, motivate, and encourage each other. Patients can also
learn about the different issues others are facing, such as their struggles or
what they have been able to overcome. This is also a good opportunity for
patients to talk about their problems with others who know how they feel
and understand what they are going through. Therefore, group therapy
sessions could be used to discuss problems in a supportive environment and
learn new skills that could be applied in real-life situations.

b. Individual therapy

Individual therapy helps identify the patient's behavioral patterns and work
with them directly. For example, the patient can discuss problems, and the
therapist can work with the patient to help them deal with those problems
in an effective way. Sometimes, individual therapy sessions prevent the
patient from engaging in impulsive behavior such as self-harming or
abusing drugs or alcohol.

c. Self-help material

This is another good way to practice DBT skills because it encourages

patients to learn how they can apply these skills in their everyday life.
Patients also avoid behaviors that could lead to addiction if they start
engaging in them on their own and then find a problem that will develop if
they stop doing so, resulting in a serious situation where they need
treatment. Self-help material is beneficial because patients can use their
time to help themselves improve and learn new skills to apply in real-life
situations.

Thus, DBT skills can be effectively used in individual therapy sessions,

group therapy, and self-help material. Through these practicums, one can
learn how to accept themselves and overcome their problems rather than
continuing down a path of self-destruction that is harmful to both
themselves and others.

d. Journaling exercise

This exercise allows patients to reflect on their feelings and apply the skills
they have learned through therapy or self-help material. For example,
patients can reflect on a situation or a feeling they have been having and
then use that as an example of how they want to handle similar situations in
the future. They can also respond differently to their past behavior to learn
from their mistakes and change for the future. Furthermore, patients can
organize their thoughts in a way that is easier for them to understand the
problem at hand because putting things down on paper allows you to see
things more clearly and put your thoughts into words instead of keeping
them bottled up inside your head.

e. Journaling on the diary sheet.

The diary sheet allows patients to take their thoughts from therapy sessions
and organize them into a written format that they can reflect on and learn
from in the future. In addition, the DBT Diary Sheet contains spaces for
multiple types of therapy, including mindfulness, distress tolerance,
emotion regulation, and interpersonal effectiveness. Therefore, all these
different aspects of DBT skills can be effectively taught through all these
different mediums to help patients develop new skills and apply them to
real-life situations to improve themselves as people.

There are several stages in DBT for targeting the treatment of patients.
First, Transtheoretical Model (TTM) is used to adjust the treatment
intensity level based on the patient's progress, which is determined by
surveys and assessments. These stages are Stabilization, Early,
Intermediate, Advanced, and Termination or Relapse Prevention.

Stabilization is a step that takes place within the first three sessions with an
individual. The therapist will decide how many sessions they would like to
have with that specific patient and what goals they want to accomplish in
those sessions. The patient and therapist should establish a stabilization
contract with goals for each session.

The early stage comprises the first 6 to 12 sessions with the individual. All
patients will go through this stage, and it is here where they will work on
establishing trust in their therapist and build a relationship with them.
During this stage, there will be an emphasis on improving self-esteem and
building more skills based on depression and anxiety. Patients here can
learn how to recognize their feelings as well as how to deal with them. They
can also learn how to accept themselves for who they are, let go of negative
thoughts, and take control of their actions rather than letting those things
control them.

The intermediate Stage is the next stage after the early stage, and it occurs
when the patient has learned some more skills and mastered the ones they
had before. During this stage, patients are encouraged to take a more active
role in their treatment and keep track of their progress. In addition, the
therapist can give patients more freedom by asking them to balance
different aspects of their life, such as work, family, or self-care. Patients are
also given homework assignments to continuing practicing what they have
learned in sessions.

The advanced Stage is for the most severe cases of patients who need
intensive therapy and extra support from the therapist and other
professionals throughout treatment. During this stage, the therapist will
work on improving skills further and provide more structure to the patient's
daily life. In addition, the patient is encouraged to continue taking care of
themselves by exercising, eating correctly, and working on their overall
health.

The termination or Relapse Prevention Stage is a way that patients can look
back through the treatment process and evaluate their progress and
effectiveness in therapy. In this stage, patients are encouraged to take
responsibility for their own lives to learn how to approach new situations to
help them reach their recovery goals instead of just avoiding them or letting
things worsen.

The main goal when practicing mindfulness is to help patients learn how to
deal with their emotions by being aware of them and learning to confront
them in healthy ways. To work with these skills, therapists need tools that
can be used in DBT sessions, such as a DBT worksheet or the Mindfulness
Journaling & Meditation for Emotion Regulation Seminar available online.
Likewise, the main goal when practicing distress tolerance is to help
patients manage their emotions without engaging in harmful behaviors,
such as self-harm or eating disorders.

Setting up a DBT skill plan

This can play a significant role in establishing a treatment plan. When
implementing skills, the therapist will need to utilize the treatment manual,
which is available online, and describe the skill set. Resistance skills, such
as mindfulness or distress tolerance, are described in the individual therapy
manual and are used to create an emotion regulation contract. For example,
if a patient were to ask for immediate reassurance from their therapist
during their session instead of working on the skill at hand, it would be
considered a resistance skill.

The therapist can give patients a DBT worksheet to help them organize
their thoughts and put them into words. This helps the patient apply what
they have learned in previous therapy sessions and implement change in
their behavior. The therapist should also use their assessment tools to
determine if the patient is ready to master the skill or if they need more
time to practice it. For example, if a patient has recently had an episode of
self-harm, they may not be ready to work on new skills, and their therapist
will have to allow them some time in this situation.

To explain the use of DBT as a complement to standard treatment for eating

disorders, it is helpful to review its origins. Linehan originally developed
DBT for patients with chronic suicidality; these patients were typically
diagnosed with borderline personality disorder (BPD). However, later
studies indicated that DBT could also be effective for patients with other
life-threatening behaviors, such as self-injury or eating disorders. It was the
first approach shown to be effective in both groups. As a result, Linehan
recognized the potential for DBT to be used with other forms of self-
injurious behavior and eating disorders.

Linehan's original focus on treating suicidal and self-injurious behavior led

people to speculate that DBT would not be effective for bulimia nervosa
(BN). Still, she did not initially consider this. Linehan has since begun a trial
with BN patients, demonstrating that DBT, which includes acceptance and
commitment therapy (ACT), is an effective treatment for BN improving body
image and disordered eating behaviors. Several other studies have also
demonstrated that DBT may be effective for BN.

Linehan initially created DBT as a treatment for self-injurious behavior

based on her work with chronic suicidality. In her original manual for DBT,
she stressed that DBT was a treatment for suicidality, not bulimia nervosa.
Despite this disclaimer, Linehan later acknowledged that BN might be an
appropriate population to use the skills in a behavioral therapy program. In
addition to Linehan's acknowledgment of BN as an appropriate population,
several other studies have also demonstrated the efficacy of the skills in
treating BN.

Therefore, DBT skills can be set up through a treatment plan to include a

bulimia nervosa-specific skill set. For example, if a patient were to use the
skills in a way that directly impacted their bulimia, the therapist would need
to intervene and teach different behaviors or explain how the patient was
misusing them.

Linehan's original DBT skills were designed for borderline personality

disorder (BPD) patients. She believes BPD patients are uniquely vulnerable
to self-injurious and suicidal behavior. The skills incorporate principles from
ACT and mindfulness therapies; these two therapies have already been
validated as having benefits for BPD patients.

How to stop self-harm thoughts and behaviors in DBT terms:

Linehan indicates that any self-harm behavior must be addressed to

challenge it. This technique can reduce the rate of self-harm or remove
harmful behaviors entirely. However, it should not replace traditional
treatments for eating disorders and self-injurious behavior because it will
have minimal effect on improving body image and reducing disordered
eating behavior. The therapist should not get overly frustrated with the
patient's repeated self-harm behaviors; instead, they should remain calm
throughout this process. The therapist should convey empathy to the patient
and accept them, even when they are engaging in dangerous behavior. They
should also help the patient develop a food journal to record their feelings
about food, eating, and hunger. This will help the patient identify their
disordered eating behavior and the triggers that prompt them to engage in
self-harming behaviors.

The therapist should measure the patient's rate of self-harm behaviors and
continue to observe them throughout treatment. If they see these behaviors
increasing, they can use specific techniques to reduce them. For example,
by using a rule such as "I will give myself one minute without cutting" or "I
will think of something else for one minute," the therapist can increase
pause periods and remove painful imagery; this has been shown to decrease
self-harm behavior. The therapist should also use a block schedule where
they stick with their scheduled time frame no matter what happens during
the session. The therapist should also help by encouraging the patient to tap
into their emotions around their eating disorder or self-harm.

Linehan describes how these techniques can be implemented to help

patients change their body image, reduce self-harming behavior, and ignore
feelings of guilt that prevent them from engaging in healthier behaviors.

For example, if patients were struggling with weight gain and anorexia
nervosa, they may have thought they were gaining weight or were not
losing weight fast enough, prompting them to engage in self-harm behavior.
Their self-harm behavior, in turn, would result in more guilt and anxiety.

To help them change their thoughts and behaviors surrounding this

problem, the therapist must work with the patient to find a way around it.
First, they should carefully listen to what the patient has to say and validate
their concerns that there is extreme emphasis or too much focus on being
thin. They should also help them find a way of accepting things they cannot
change instead of becoming preoccupied with things they cannot control.
The therapist can also help them explore their feelings about weight and
eating using paradoxical intention; this involves agreeing with the patient
that life would be easier if they were thinner, for example. The patient then
has to do things opposite to their goals to learn more about themselves and
gain awareness of things that bother them.

The therapist should then help the patient identify their self-harm behaviors
and help them by teaching new skills or ways to deal with these behaviors.
For example, they should encourage the patient to develop new exercises
focusing on physical activity, such as walking or jogging, instead of
engaging in harmful behaviors. They can also teach them to focus on
"physical" sensations like breathing and their feet touching the ground
instead of negative body image thoughts. They should also encourage the
patient to practice these exercises in between sessions. If patients continue
to engage in harmful behaviors, they should observe them throughout
treatment and remind them that they are there to support and work with
them. They should also help the patient identify their feelings around body
image, eating disorders, self-esteem issues, and emotions surrounding this
problem. The therapist can then use behavioral experiments to help the
patient identify behaviors associated with positive or negative feelings and
target those specific behaviors.

For example, if a patient struggles with self-harm behaviors because of

depression and suicidal thoughts, they should learn new ways to cope with
negative thoughts and reduce overall stress. These techniques will reduce
their urge to self-harm. The therapist must help the patient break things
down into smaller parts so it is easier to tackle their problems in a
manageable way. They should also be sure that the problem is not due to
medication issues or any other condition or disorder that may impact them
negatively. In some cases, they may need new medications or supplements
to help manage the symptoms of the disorder or illness they are struggling
with. The therapist should examine their options, including medical
treatment and other options, such as therapy.

To help patients change their disordered eating/body image habits, they can
do behavioral experiments where they try to challenge their negative body
image thoughts. Negative thoughts typically correlate with bad behaviors
and self-harming behaviors. Linehan suggests that patients use an "A" list
(Positive) of positive thoughts and associate these thoughts with a negative
or frightening emotion so that it is easier to remember them. They should
then use a "B" list (Negative) of negative thoughts and associate these with
a non-hostile/non-fearful emotion so that it is easier to remember them.

What are some examples of how people use DBT in their lives?

They may find it useful in assisting them with building a more positive and
intimate relationship with their significant other.

They may find it useful when struggling with self-esteem in the workplace
or school. In addition, it can be helpful for people who do not feel they are
getting the recognition and feedback they deserve.

They may find it helpful when they have a bulimic or anorexic relationship
with food, which is common among people with BN, for example. It can help
them learn more about what triggers these behaviors and how to cope
better if they want to avoid relapse.

It can also be helpful for people who have a history of having trouble with
alcohol and drug abuse. It is believed that by using DBT, they will find it
easier to achieve and maintain sobriety.

They may find it useful when they are trying to develop better
communication skills. This can be useful in helping them become more
effective communicators at home, school, and work.

It can also help people with anger management problems because it teaches
them new ways of coping with their anger, such as trying not to get angry in
the first place or finding better ways of managing their anger rather than
engaging in self-harming behaviors or engaging in an unhealthy
relationship.

It is also believed that it can help people with eating disorders who are
struggling with depression, substance abuse, self-harm, and

Dating violence can also be prevented and healed using DBT.

It can also be helpful for people who have a history of struggling with
interpersonal relationships.

Although all of the above examples benefit many people who struggle with
various issues in their lives, it is important to note that this therapy is only
available to those who meet certain criteria. It may be useful for some time,
but in the end, there may not be a good fit between you and your therapist.
Don't be afraid to break away if the fit is not there. It may be the best thing
for you, or it may just be that you are not a good fit for DBT treatment.

A great analogy for this technique is the road map of a city. Following a
map set, routes allow you to arrive at your destination safely and quickly.
Knowing which roads to take and in what order, you can reach your
intended destination efficiently and effectively. Likewise, in DBT, you must
know your landmarks to achieve your recovery goal.

DBT is a cognitive, behavioral, and dialectical approach to treating

numerous mental health disorders. Dr. Marsha Linehan developed it in the
1980s at the University of Washington. Despite its development more than
thirty years ago, it is still considered one of the most effective and
innovative therapies available today for treating Borderline Personality
Disorder BPD, as well as other mental disorders such as depression, eating
disorders, and substance abuse. In fact, in 2006, the United States
Department of Health and Human Services, Substance Abuse and Mental
Health Services Administration Research Division awarded Dr. Linehan a
$1.9 million grant to research DBT treatment for suicidal adolescents.
 How to use DBT to treat borderline personality
disorder effectively.
Dialectical Behavior Therapy (DBT) is a treatment for Borderline Personality
Disorder that effectively reduces the symptoms of borderline personality
disorder. DBT was developed by Marsha Linehan and was originally used as
an application for cognitive behavior therapy to reduce the symptoms of
chronic or suicidality among individuals with a borderline personality
disorder. Given the high mortality rate among individuals with borderline
personality disorder, this therapy has proven so successful in ameliorating
symptoms that it has expanded into other areas like substance abuse
treatment and anger management. Although DBT is by no means a cure for
Borderline Personality Disorder, it is possible to use this form of therapy
effectively to minimize the symptoms of borderline personality disorder.

Most people with borderline personality disorder who suffer from

depression are unaware of the intense amounts of pain they are
experiencing daily. When emotions become too painful or difficult to
manage, individuals will often attempt to repress them through addictive
behavior such as substance abuse, risky sexual behavior, and suicide
attempts. For many individuals, this process often continues for many years
until the person realizes that they have a serious emotional disorder that is
destroying their quality of life. The symptoms of borderline personality
disorder are so intense they often feel impossible to manage daily.

The first step in treating a borderline personality disorder is identifying how

intense the person's emotional pain is and how they manage it. Individuals
with borderline personality disorder typically tire themselves out by
repressing all their emotions and attempting to control them with addictive
behaviors such as substance abuse, risky sex, and suicidal behavior.

This condition is characterized by extreme instability in moods and

interpersonal relationships, as well as an intense fear of abandonment.
Because of this instability, borderlines are often very self-conscious and
anxious. They often feel that people judge or condemn them for their
feelings and behavior. As a result, they may become angry or depressed
when these feelings arise because they believe others should never feel the
same way they do.

Research suggests that borderline personality disorder is genetic

(inherited) but isn't caused by a specific illness or brain injury since
symptoms can be found in people with a family history of depression and
those without one. Instead, research suggests that it is a combination of
genetic and environmental factors contributing to the development of
borderline personality disorder. However, researchers are still trying to
understand exactly what causes this condition.

It has been suggested that personality disorders like borderline and

dissociation manifest a single underlying process or psychological
pathology. However, researchers aren't quite sure what this process is. This
would mean that the cause of borderline personality disorder may not be a
single thing but instead the result of various unconscious processes
interacting with each other and external stimuli. In addition, research
suggests that borderline personality disorder occurs more frequently in men
than women.

Symptoms of borderline personality disorder

Most people with borderline personality disorder struggle to control their

emotions, feelings, thoughts, and behavior. They often experience intense
fear, anger, or guilt when they feel out of control. Four major symptoms
associated with borderline personality disorder include:

Over time, these symptoms will become more and more extreme as the
person with borderline personality disorder struggles to cope with the pain
they are feeling in reality and their minds. This will cause them to continue
to push away those who try to reach out to them or help them cope.
Borderlines may also make attempts at suicide as a result of the stress they
are experiencing.

Individuals with borderline personality disorder can exhibit a wide range of

symptoms. Some of these symptoms are:

a. Frantic efforts to avoid real or imagined abandonment.

b. A unstable and intense interpersonal relationship pattern characterized
by idealization and devaluation (sometimes called "splitting").

c. Identity disturbance: markedly and persistently unstable self-image or

sense of self.

d. Impulsivity in at least two potentially self-damaging areas (e.g., spending,

sex, substance abuse, shoplifting, reckless driving).

e. Recurrent suicidal behavior, gestures, threats, or self-injuring behavior

such as cutting or burning oneself.

f. Affective instability due to a marked reactivity of mood (e.g., intense

episodic dysphoria, irritability, or anxiety usually lasting a few hours and
rarely more than a few days).

g. Chronic feelings of emptiness.

h. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent

displays of temper, constant anger, recurrent physical fights).

i. Transient, stress-related paranoid ideation or severe dissociative

symptoms.

j. Markedly disturbed function of identity: markedly and persistently

unstable self-image or sense of self (e.g., fragmentation of identity).

A borderline personality disorder is often associated with negative social

consequences, as it can lead to unstable relationships, problems with
addiction, and sometimes self-harming behaviors. Because of this, many
people suffering from this condition have difficulty maintaining stable
employment. Many also have legal issues or other problems in the
workplace due to their behavior.

However, research has shown that treatment with psychotherapy and

medications for borderline personality disorder helps alleviate symptoms
and improve daily functioning.

The underlying cause of borderline personality disorder is still unknown.

The following theories are just some researchers' ideas about what might
maintain or exacerbate borderline personality disorder symptoms.
a. Social learning theory suggests that specific environmental factors
contribute to the development of borderline personality disorder. This
would mean that even children born with a predisposition towards this
condition could be helped by changing their environment, though they may
still have to deal with the pain caused by it.

b. Cognitive processing theory suggests that people suffering from this

condition interpret certain situations in a way that causes them to feel
extreme emotions and behave in ways that don't always benefit themselves
or others.

c. Object relations theory suggests that patients with borderline personality

disorder have a distorted view of themselves and others in their lives that
may cause them to behave in ways that are self-destructive or harmful to
others.

d. The biological model suggests an imbalance in certain chemicals like

serotonin that affect brain functioning, which can lead to symptoms of
borderline personality disorder. This does not mean, however, that the
condition is cured by simply correcting the chemical imbalances.

e. The psychoanalytic perspective suggests that this condition can result

from an unresolved childhood conflict between a child and their parent and
other family members, which can lead to serious issues throughout
adulthood.

Since many people with borderline personality disorder go undiagnosed for

a long time or are diagnosed with other disorders, it is important to use an
effective and efficient method to identify and treat those suffering from this
condition.

a. The most effective way to diagnose borderline personality disorder is by

using one of the diagnostic manuals utilized by mental health professionals
in hospitals and clinics. These diagnostic manuals will have lengthy
questionnaires that can be used to assess a patient's symptoms to
determine whether or not they have a borderline personality disorder and
other possible conditions that might be causing their symptoms.
b. If a patient has a borderline personality disorder, it is crucial to find a
therapist who has experience treating people with this condition. This will
ensure that the patient receives the most personalized and effective care
possible.

To minimize cognitive distortions, patients can be taught to recognize them

by their therapists and then reframe them in more positive ways.

Other techniques used for BPD include Dialectical Behavior Therapy (DBT)
and Mentalization-Based Therapy (MBT). In addition, emotion regulation
therapy teaches individuals with BPD how to regulate emotions, so they
remain in control of themselves, whereas general psychotherapy uses
individual, family, or group approaches to help patients learn basic skills
such as communication and problem-solving.

Society's distorted view of BPD can result in overgeneralizations,

misconceptions, and other negative attitudes, which may worsen an
individual's symptoms. One reason for the stigma surrounding BPD may be
that it is commonly associated with violence and aggression. It is important
to understand that while patients with this personality disorder are at a
significantly greater risk of having violent moments than others, they are
far more likely to be the victims of physical and mental abuse. Recognizing
risk factors such as childhood abuse, substance abuse, homelessness,
unemployment, or living alone can help individuals avoid placing
themselves in potentially dangerous situations. A common issue for
borderline personality disorder patients is dealing with abandonment
issues. The fear of being rejected is intensified when people suffering from
BPD have relationships, jobs, or any other aspect of their lives end abruptly.

It is also important for individuals without BPD to understand that the

disorder does not mean a person can't be helped. There are effective forms
of treatment for borderline personality disorder, and those with the disorder
can lead healthy, functional lives with proper help.

The main symptoms of a borderline personality disorder usually begin in

adolescence or early adulthood and continue throughout a person's life.
People with this condition can have intense mood swings, impulsive
behavior, lack self-control, and struggle to make decisions about their lives.
The following symptoms may be present in people with BPD:

Impulsivity – individuals with borderline personality disorder are sometimes

impulsive and make decisions without considering the consequences. This
can cause issues with relationships, jobs, school, and other aspects of their
lives.

Somatic blame – patients with a borderline personality disorder may feel

that everyone else is responsible for their problems and has no control over
what happens to them. This can lead to depression and anxiety.

Unstable relationships - These disorders can often lead to an unstable

relationship with significant others because of their impulsive behavior,
mood swings, and other problems with self-control.

Intense periods of sadness or distress – a person with a borderline

personality disorder is likely to have constant feelings of sadness, anxiety,
or other forms of intense emotional distress.

Self-harming behavior - Some people with BPD may engage in self-harming

behaviors to cope with their internal pain and other problems. As a result,
many people suffering from BPD may be at risk of being suicide bombers or
committing terrorist acts.

Suicidality - Individuals with borderline personality disorder can be at

extremely high risk for committing suicide because of their unstable moods
and tendencies towards impulsive behavior.

Lack of emotion control - a person with a borderline personality disorder,

may find themselves unable to regulate their emotions and may engage in
dramatic emotional outbursts such as rage, sobbing, and other forms of
emotional distress.

Emotional numbness – Often, a person who has borderline personality

disorder will have to struggle for years before they can express feelings that
are stronger than feelings of emptiness.

Anxiety - the feeling of constant fear is often present throughout a person's

life with borderline personality disorder, making them susceptible to
anxiety disorders such as OCD, panic attacks, or general anxiety.
Depending on the patient’s needs, your sessions could vary anywhere from
once a week to once every couple of months.

Cognitive Behavioral Therapy (CBT) is an essential part of DBT. This can

include skills such as calming oneself down when faced with emotional or
threatening situations. The DBT therapist and the patient work together to
learn ways to calm one’s emotions and feelings down to a non-destructive
point.

For DDT to be effective, patients must have had some therapy prior so that
their therapists may properly diagnose their disorders and treat them
accordingly.

The goal of a therapist is to help patients learn how to form healthy

relationships by using behavioral and cognitive techniques.

In addition, the therapist helps patients work on their emotions and provide
support in self-care, coping skills, and communication.

Despite the reality that people with BPD can be helped through DBT, we all
must understand that this condition cannot be helped if not treated properly
at an early age.

Similar Treatment Approaches From Other Mental Health Specialties For

Borderline Personality Disorder

Another important aspect of treating borderline personality disorder,

specifically for children with this disorder, is family therapy.

One such therapist who has found success with families around the country
is Dr. Jill Myra Henningsen, a licensed clinical social worker and family
therapist from Wisconsin.

In an interview with The National Association of Social Workers,

Henningsen stated that families often are in denial about their borderline
children's issues, so it takes time to work through their problems together.

She also said that children struggling with a borderline personality disorder
might have other issues, such as eating disorders or previous trauma, that
must be addressed.
In another interview, Henningsen stated that "borderline parents often have
loveless relationships with their children because they don't know how to
express their love and rage in healthy ways."

Henningsen has used her expertise in family therapy to help families get
through difficult times and help families through transition.

When it comes to teens and young adults, there is far less research on
borderline personality disorder than there is for adults.

This means that fewer experts specialize in treating this population of

patients. Therefore, it is crucial for teenagers struggling with these
disorders to seek help as early as possible if they want treatment to be
effective.

DBT is a form of psychotherapy that has been used with a variety of

disorders, such as PTSD and eating disorders.

Because these disorders have very similar symptoms, including outbursts

and mood swings, it was assumed that DBT would effectively treat
borderline personality disorder patients.

DBT is used to help patients in therapy practice skills that can help them
learn how to control their feelings and reduce the impact that negative
feelings may have on their lives and relationships.

Most people suffering from BPD find themselves in therapy with a therapist
who specializes in cognitive behavioral therapy.

These skills can be taught to patients in therapy over six to twelve weeks. If
a patient is not doing well with this therapy and does not feel their
symptoms are adequately treated, the therapist may elect for DBT instead.

While DBT is effective for treating BPD, it is important to know that some
experts recommend against this form of treatment for borderline
personality disorder altogether.

This stems from the fact that DBT does focus on changing the dysfunctional
thoughts and behaviors associated with BPD, which can cause unwanted
changes in mood, outbursts, and honesty issues on a day-to-day basis.
This can harm the patient suffering from BPD and the people they are close
with.

DBT is an effective form of therapy for a wide range of disorders and

illnesses. However, as some illnesses can be treated differently, so can
borderline personality disorder.

The reality is that there are few studies available regarding how effective
DBT is when it comes to treating patients who have borderline personality
disorder.

This means that the truth about whether or not this therapy is effective for
BPD may not be known for quite some time.

DBT is a form of psychotherapy that has been used with a variety of

disorders, such as PTSD and eating disorders.

Because these disorders have very similar symptoms, including outbursts

and mood swings, it was assumed that DBT would effectively treat
borderline personality disorder patients.

DBT is used to help patients in therapy practice skills that can help them
learn how to control their feelings and reduce the impact that negative
feelings may have on their lives and relationships.

Most people suffering from BPD find themselves in therapy with a therapist
who specializes in cognitive behavioral therapy.

These skills can be taught to patients in therapy over six to twelve weeks. If
a patient is not doing well with this therapy and does not feel their
symptoms are adequately treated, the therapist may elect for DBT instead.

While DBT is effective for treating BPD, it is important to know that some
experts recommend against this form of treatment for borderline
personality disorder altogether.

This stems from the fact that DBT does focus on changing the dysfunctional
thoughts and behaviors associated with BPD, which can cause unwanted
changes in mood, outbursts, and honesty issues on a day-to-day basis.

This can be harmful to the patient suffering from BPD and the people they
are close with.
DBT is an effective therapy for a wide range of disorders and illnesses.
However, as some illnesses can be treated differently, so can borderline
personality disorder.

The reality is that there are few studies available regarding how effective
DBT is when it comes to treating patients who have borderline personality
disorder.

This means that the truth about whether or not this therapy is effective for
BPD may not be known for quite some time.

One of the reasons experts believe that DBT may not be recommended for
borderline personality disorder is because the patient's partner influenced
their recovery.

The partner may feel afraid to seek treatment for themselves because they
worry that their partner will leave them if they receive treatment.

This, in turn, can cause the patient to continue suffering from a borderline
personality disorder and draw out the period in which therapy may be
ineffective.

If a therapist or family member believes that a patient's behaviors indicate

borderline personality disorder, getting them help as soon as possible is
important.

The earlier patients seek help, the sooner they can start working on
changes to their behaviors and relationships with others.

The longer a patient suffers from BPD, the more likely they feel out of
control and hopeless.

If they can seek help early in their disorder, they are much more likely to be
able to improve the way that they feel and start showing signs of remission.

It is important not to wait until your loved one's symptoms become

unmanageable because this can lead to a breakdown in your relationship
with them.

Doing everything you can to get them help is the best action if you believe
they may have a borderline personality disorder.
Even if a patient can continue being in therapy and successfully practice the
skills introduced, it is still important for them to develop other skills for
managing life after therapy.

It is possible for patients with borderline personality disorder who

experiences a change in their symptoms from BPD to take these skills with
them for the rest of their lives.

This will allow the patient to be able to control their emotions better and
able to deal with issues on a day-to-day basis.

The long-term effects of DBT depend on certain factors but can help
patients live happier lives.

This depends on the patient's willingness to learn new habits and desire to
improve.

This may not be necessary for patients who feel their life is already in chaos
and that they cannot make any changes.

If patients have difficulty learning new skills, they may want to look into
other options to help better them control their lives and emotions.

The long-term effects of DBT depend on certain factors but can help
patients live happier lives.

This depends on the patient's willingness to learn new habits and desire to
improve.

This may not be necessary for patients who feel their life is already in chaos
and that they cannot make any changes.

If patients have difficulty learning new skills, they may want to look into
other options to help better them control their lives and emotions.

Various treatments for a borderline personality disorder are available,

including DBT and cognitive behavioral therapy.

The main difference between these two therapy forms is the therapist's
approach.
This can have very different outcomes because the symptoms of BPD tend to
change daily, making it difficult for a therapist to predict how a patient will
respond in treatment sessions.

A borderline personality disorder is characterized by instability in mood,

self-image, relationships, and impulsivity. Dialectical behavior therapy
(DBT) was introduced in the 1980s to treat people suffering from borderline
personality disorder's debilitating symptoms by teaching behavioral skills.
This therapy is based on the belief that people with borderline personality
disorder and their families are stuck in an "emotional conflict loop," in
which they feel helpless and often act out in destructive, self-destructive
ways. The goal of DBT is to help patients move out of this negative cycle by
supporting them with healthy coping skills, improving communication skills,
and building a relationship with a therapist that encourages patients to take
charge of their own lives.

There were two main components of DBT that Marsha Linehan, Ph.D.,
identified. These two parts included individual psychotherapy and group
skills training. The individual psychotherapy techniques included
psychoeducation and mentalization-based treatment. Psychoeducation helps
patients learn to accept their emotions without fear of consequences.
Mentalization-based methods helped patients develop the ability to observe
their behavior, as well as the behavior of others.

The other part of DBT was the behavioral training groups that focused
mainly on safety behaviors, emotion regulation strategies, distress tolerance
strategies, and interpersonal effectiveness strategies.

Though DBT effectively treats people with various emotional issues, it

focuses on social and interpersonal skills such as emotion regulation and
mindfulness. This book will explore how DBT is used to treat borderline
personality disorder specifically and share some tips for successfully
incorporating DBT into your treatment regimen.

The main goal of DBT is to help patients regain control over their emotions
and behaviors.

This therapy has a lasting effect because most people who complete it
continue to practice the skills introduced.
Therefore, if you believe that your loved one should consider therapy for
borderline personality disorder, you can introduce them to DBT now so they
can start practicing these skills immediately after the therapy session.

Although many people believe that there are only two possible outcomes of
therapy: cure or death, this isn't always the case. Various therapeutic
methods can be used to treat patients with borderline personality disorder,
and each has its advantages and disadvantages.

You may want to consider DBT if you believe your loved one needs these
skills to improve. The best thing you can do is research the therapy and
decide based on what's best for them.

If you decide DBT may be the best option, a few things need to happen.
First, your loved one must attend at least five therapy sessions before
resuming their everyday lives.

This lets the therapist evaluate their progress and implement new
strategies if necessary. If patients cannot attend therapy regularly, it may
be difficult to learn how to manage their behavior and emotions effectively.

The next chapter will discuss Acceptance and Commitment Therapy. This is
a type of therapy used to help the patient feel at ease and cope with their
emotions. Moreover, this therapy helps them be more aware of the issues
associated with their borderline personality disorder. Sometimes, people
with this condition feel anxious and worried about their physical health or
what others think about them. This is sometimes referred to as being
emotionally dysregulated.

Emotion regulation is the ability to adapt to your environment accordingly.

Unfortunately, many people with BPD often have difficulty doing this
because they feel trapped by their emotions; any change in emotion feels
like a double-edged sword.

Various techniques can be used to treat borderline personality disorder, but

CBT, DBT, and ACT are the most effective. After a patient is diagnosed with
BPD, individual therapy may be necessary to determine how their symptoms
affect daily life. One of the simplest and most effective ways to treat
borderline personality disorder is through acceptance and commitment
therapy (ACT).

ACT was developed by Steven Hayes, Ph.D., who recognized that patients
with BPD have difficulty recognizing and dealing with their emotions. This is
often done unconsciously, so it is difficult for them to make rational
decisions about their behavior as emotionally dysregulated patients tend to
engage in excessively risky behaviors.
Chapter 3. ACCEPTANCE AND COMMITMENT THERAPY
 What is ACT?
Acceptance and Commitment Therapy (ACT) is a psychological intervention
that introduces mindfulness and acceptance-based techniques. The ACT's
goal is to help people become more aware of their thoughts, emotions,
fears, and physical sensations to make changes that bring greater well-
being.

Acceptance and Commitment Therapy is based upon the work of Steven C.

Hayes, Ph.D., a clinical psychologist; Kelly G. Wilson, Ph.D., a
behavioral/cognitive psychologist and researcher; Russ Harris, Ph.D., a
clinical psychologist who introduced ACT to the general public through his
book "The Happiness Trap," and their colleagues at the University of
Nevada Reno. The name "Acceptance and Commitment Therapy" was
initially proposed for what was then called "behavior therapy" by Charles
Swenson in 1978 and later published in 1979. ACT was then identified as
"therapy in which clients practice accepting the present without judging it
as good or bad, right or wrong." The first full-scale ACT program, based on
Hayes and Wilson's acceptance-based model of psychotherapy, was a
university-based clinical program at the University of Nevada Reno. ACT
became fully accredited in 1992 under the name "Acceptance and
Commitment Therapy: An Experiential Approach to Behavior Change" by
the American Psychological Association.

ACT is based on several principles. Most significantly, ACT aims to help

people live rich and meaningful life. The ACT model is mainly used for
treating problematic areas of human functioning, including clinical
depression, chronic pain, bipolar disorder, eating disorders, substance
abuse, and personality disorders. ACT also promotes applied research on
human functioning related to health, educational attainment, occupational
performance, and other quality of life indicators.

Hayes and colleagues developed a 6-level hierarchical model (or "hexaflex")

describing the process individuals may undergo in resolving psychological
problems. This level model has been applied to various psychological and
behavioral difficulties such as depression, generalized anxiety disorder
(GAD), borderline personality disorder (BPD), psychosis, and pain-related
issues.

In the model, difficulties can be categorized into low, moderate, and high-
intensity categories. The goal of ACT is to help people accept and work
through their problems with the hope that they will move to higher levels of
functioning.

ACT uses mindfulness techniques in both the treatment and mediation

sessions. Mindfulness is defined as paying attention in a particular way:
non-judgmentally, on purpose, and for the duration. Mindfulness techniques
focus on bringing awareness to the current experience without judging it as
good or bad, right or wrong. The first step in the ACT is usually cognitive
defusion: identification of internal thoughts (cognitions) attached to
negative emotions (feelings).

ACT is founded upon the premise that we all can create our own experience
of the present moment. For example, suppose a person can believe they can
experience happiness even when it may be difficult or that they can accept
themselves even when they do not feel good. In that case, they will feel
safer in making decisions and being with others in the present moment. The
belief in one's ability to shape one's experience, called self-efficacy, is
critical in the ACT. In this way, people are more likely to take risks and be
willing to explore new possibilities for how their life may unfold rather than
staying stuck in pre-existing patterns of behavior.

The formal development of ACT started in 1978 at the University of Nevada,

Reno, where Steven Hayes was a psychology professor and Kelly Wilson
was a doctoral candidate. After reading "The Power of Awareness" by Viktor
Frankl, Hayes and Wilson developed "behavior therapy." This early form of
ACT involved patients identifying their problems and then actively trying to
solve them.

In 1979, Charles Swenson read an book by Hayes about this work. He was
impressed with Hayes' work and knew he wanted to replicate it more
comprehensively. Swenson discussed his ideas with Kelly Wilson, and a
more comprehensive ACT version was conceived. This new approach would
be called "ACT" by its first practitioners.
In the 1980s, the first formal ACT program was developed by Hayes, Wilson,
and their colleagues at the University of Nevada Reno. This program used a
treatment manual that detailed Hayes' model of psychotherapy as well as
practical exercises for clients to learn how to develop self-acceptance and
"habituate" thoughts and emotions toward acceptance. The program began
in 1982 when there were only seven clients; now, there are over 1,300
annually.

Over the next decade, ACT was refined and developed through exposure by
word of mouth, journal books, and papers presented at professional
conferences. ACT was presented in Swenson's book "The ACT Works" in
1993. This book helped popularize the practice of Acceptance and
Commitment Therapy.

ACT was established as a formal course at the University of Nevada Reno in

1995 and eventually became a doctoral program in 2000. In 2002, the first
non-residential training was offered for practicing clinicians and started an
increasing interest in Acceptance and Commitment Therapy. In 2006, the
university formally approved acceptance and commitment therapy as a
Ph.D. program in Clinical Psychology with Dr. Russ Harris as director of
graduate studies and Dr. Kelly G Wilson as chief supervisor of students.

In 2000, the first accredited ACT certification training was developed by

Russ Harris and Douglas E. Hart at Flinders University in Adelaide, South
Australia. The European Association for Behavior Analysis International
Conference held in Budapest in 2003 included a particular track on
acceptance and commitment therapy (ACT). This conference provided an
opportunity to present and discuss the evidence for the ACT as a viable
treatment approach. The International Association of Behavior Analysis
(IABA) has been promoting interest in the ACT since then. The American
Psychological Association approved Acceptance and Commitment Therapy
as a third-wave CBT approach in 2006. The National Institute for Health in
the United Kingdom funds a network of ACT practitioners and ACT training
organizations.

Theresa Summerford, a University of Nevada Reno student, developed a

new model in 2006 that would lead to increased emphasis on mindfulness
and acceptance exercises in clients' work. This resulted in a therapeutic
approach that involves both cognitive defusion and behavioral practices
aimed at facilitating client acceptance of unwanted thoughts and emotions.
This approach has become the basis for Acceptance and Commitment
Therapy.

ACT is a relatively new approach to therapy and has been subject to much
debate. Proponents of ACT claim it can be used as a treatment for
difficulties such as depression and anxiety, whereas some cognitive
behaviorists have challenged the evidence for these claims. A review of
available studies found that results regarding the effectiveness of ACT for
anxiety reduction are somewhat mixed. Some studies show positive results,
whereas others do not. Similarly, research on depression treatment with
ACT has varied as well.

The following are characteristics of those who might benefit from ACT:

Certain people with specific traits seem to benefit from ACT and vice versa.
However, the following are general characteristics that can include ACT
users and benefit recipients.

ACT uses an acceptance-based approach that focuses on how clients can

become aware of any unwanted thoughts or feelings, pay attention to them
as opposed to reacting to them, and then let go of these thoughts and
feelings. This process can be accomplished with a variety of exercises.

The first step in the therapy is called self-disclosure. The therapist starts by
asking the client if they would like some time to talk about what is
bothering them. The therapist then discusses with the client the difficulties
they are experiencing. During the self-disclosure, the therapist helps
identify the client's strong thoughts or feelings and then coaches them
through three critical acceptance exercises.

The first exercise of accepting thoughts is called defusion. The therapist

asks a client to repeat their negative thoughts out loud. The client should
then focus on these statements and try not to judge them as good or bad but
instead focus on what it would be like if these thoughts were accurate and
accept them as a fact. The next step is letting go of these feelings. In this
exercise, the therapist might start by asking clients to acknowledge that
they feel this way without reacting emotionally or judging themselves.
This process is continued with the third exercise, which involves focusing on
positive thoughts, then accepting these thoughts without resorting to
judging oneself.

The ACT goal is to help clients become aware of the source of their
emotions and worries and then let go of those thoughts or feelings. So
often, a person experiences difficulty in controlling their emotions and
worrying about events that may not occur. This is because humans are born
with limited knowledge about the world and tend to have preconceived
ideas about what others or imagined circumstances might be like. ACT
addresses this by teaching clients how to accept uncomfortable states so
that they can relax in them instead of getting caught up in them. This can
ultimately reduce unwanted and excess emotions that may have been
causing distress in clients.

ACT uses a similar approach to CBT as its third-wave counterpart but

differs in its use of mindfulness practices such as low focus awareness,
acceptance, and defusion to evoke change. ACT has been adapted into over
20 languages.

ACT works by focusing on the difference between internal and external

events. Individuals have thoughts and subjective evaluations of their
environment and behavior, but they also have beliefs about those same
thoughts. For example, the view that I am a bad person is an internal event,
while the idea that I am bad is an external event. ACT has four steps that
help to identify the differences between these events and then change them:

The goal of this therapy is not to get rid of all unwanted thoughts or feelings
but to notice them when they happen so that they can be accepted as part
of life without being judged as positive or negative by a client. This process
helps clients to get themselves without trying to control others. This process
is carried out through a series of exercises.

The first exercise in the ACT is to become aware of negative thoughts and
not try to control them or change them into something else. This can be
done by repeating the sentence, "I'm a bad person," for thirty seconds
without reacting emotionally.
The second exercise involves noticing thoughts and feelings in your body
during stressful situations. The goal is to enhance awareness of self, with
acceptance towards whatever is taking place at that moment. It can also
help you accept rejection if you strive for a goal.

The third exercise in the ACT is to notice your thoughts and then gently try
to let go of them. A client is asked to repeat a negative thought or feeling
(for example, "I'm stupid") for thirty seconds and then stop thinking about
it. This allows them to become more aware of their thoughts without
judgment.

The fourth exercise in ACT focuses on noticing internal experiences, such as

feelings and bodily sensations. Instead of focusing on the thoughts or
events, the goal is to allow participants to see these without reacting. This
can be used by those who have trouble accepting their problems or being
alone with these thoughts.

The fifth exercise in ACT involves noticing one's thoughts and feeling,
acting on them, and then letting go of them. This includes taking a few deep
breaths and noticing thoughts and feelings during this time.

The last exercise in ACT aims to notice one's thoughts, feelings, and bodily
sensations without trying to change or control them. The client then pays
attention to the present moment for thirty seconds without reaction. This
allows one to become aware of the present without being caught up in their
thoughts or feeling.

Sanderson and Bolen (1982) conducted a study in which they followed eight
people through the course of the therapy. Six months later, they were
interviewed to see how their thoughts had changed since the treatment.
They found that all participants remembered more thoughts than could be
accounted for by chance. However, overall, they did not notice significant
changes in other mental health variables, such as mood and behaviors.

While there is some evidence that ACT may be effective for anxiety
disorders and depression, it is unclear how well it works across differently-
identified populations like children or adolescents with anxiety disorders or
obsessive-compulsive disorder (OCD). Research on the effectiveness of ACT
is limited to randomized studies and has not been consistently replicated in
controlled studies.

Basics of ACT
Acceptance and Commitment Therapy is a proactive approach to problem-
solving that uses acceptance, mindfulness, and values-based decision-
making. ACT focuses on the change process rather than being fixated on the
outcome. The goal of ACT is to increase psychological flexibility and
improve self-awareness.

ACT encourages experiential learning through mindful inquiry to examine

one's reactions in challenging situations. This allows for an increased ability
to commit and adjust behavior accordingly due to increased awareness of
one's feelings, thoughts, intentions, values, and behaviors related to these
feelings/thoughts/intentions. While ACT can be applied in many ways, three
fundamental principles are openness, responsiveness, and values-based
decision-making (VBDM).

a. Relabeling: Identifying a problem as a "thought" or "feeling" reduces

focus on managing the problem as a threat, while it can also help disengage
from the problem.

b. Reattribute: Disentangle and disidentify from thoughts and feelings by

recognizing their transient, subjective and psychological nature and how
they are conditioned by an individual's history of experiences, perceptions,
and culture.

c. Refocus: Act differently rather than thoughtfully to calm remaining

thoughts and feelings that may lead to maladaptive behavior. This may
include distraction techniques or acceptance of one's experiences.

d. Revalue: Appreciate the usefulness of values-focused decision-making to

make decisions that can be very effective during difficult situations.

e. Replot: To make plans to commit and circumvent the problem while

maintaining one's values

f. Values-Based Decision Making (VBDM): This involves choosing a practical

behavioral course of action by examining values in various situations, with
emphasis on living a life that is consistent with these values and behaving in
ways that contribute to living a valued life

g. Self as Context: A sense of self as compassionate, non-judgmentall, and

consistent when responding to others, rather than an individual that acts
based on internal reactions or thoughts.

The treatment of depression has been well studied using Acceptance and
Commitment Therapy (ACT) as a model for psychological treatment. One
study found that ACT may be as effective as Cognitive Behavioral Therapy
(CBT) in treating depression over eight weeks, with a more significant
number experiencing remission in both ACT and CBT than in a waitlist
control condition after 16 weeks of treatments.

ACT process

The ACT process may be divided into five elements:

a. Reflective Listening

b. Relabeling

c. Emotional Freedom Technique (EFT)

d. Values-based Decision Making (VBDM)

e. Commitment Therapy (CT) or Commitment Practice (CP).

Reflective listening is the first step in the ACT and is also known as self-
observation. It requires the client to recognize and name their thoughts,
feelings, intentions, and actions related to a situation. This allows more
profound insight into their mental processes that may lead to unhelpful
behavior or thought patterns. Reflective listening helps the client examine
their thoughts and feelings concerning how they are engaging with the
situation, rather than simply engaging in a "fight or flight" response by
either defending themselves against an inappropriate thought or trying to
distance themselves from an uncomfortable feeling.

This is followed by relabeling, where a problem can be re-defined as being

more meaningful than it initially seemed based on one's values. This
involves individual values and how to live with these values in everyday life.
Relabeling also examines how thoughts and feelings are formed from
conditioning through one's experiences, perceptions, and culture. Once this
is accomplished, the client must learn to refocus on the value that is
important for them in the current situation and commit to acting in
accordance with it.

EFT involves tapping on acupoints that can be accessed through the client's
body, often while experiencing some form of emotional reaction or conflict.
This allows access to positive emotions, which can subsequently enhance
self-awareness and dynamic flexibility by allowing one to recognize their
thoughts and feelings as being subject to change by choice.

Values-based Decision Making involves examining values in various

situations, emphasizing living a life that is consistent with these values, and
behaving in ways that contribute to living a valued life.

ACT also teaches clients how to make commitments. Commitments are

made by the client deciding on how they will commit each day and then
taking action according to the commitment. This is known as commitment
therapy or commitment practice. This therapy is effective in many different
areas, including criminal behavior, social relationships, and substance
abuse.

Davies and Howson (1994) investigated the effectiveness of ACT in teaching

a range of people to form new mental health beliefs about their symptoms
based on their values for self-care. They also examined its effectiveness as a
treatment for depression. The main focus of therapy was to help people
better understand why they have become depressed and try to change how
they thought about themselves and their lives. The results showed that after
treatment, depression was reduced, and participants had significantly
better scores on all measures of psychological health, such as life
satisfaction.

ACT is an evidence-based treatment for depression that is effective for

individuals with depression. It teaches clients about their thoughts, feelings,
and behaviors contributing to their symptoms of depression and negative
thinking patterns while teaching them how to work through those patterns
in a values-based way.
Additionally, ACT helps clients understand that their symptoms are not
"who they are" but rather the result of conditioning (fear of failure and low
self-esteem) based on their history (past experiences), perceptions (how
they judge themselves), and culture/environmental factors (what society
tells them). It teaches clients how to understand this conditioning better.
Finally, ACT teaches clients that their symptoms of depression can be
changed by changing how they think about and view themselves, which in
turn allows them to change how they relate to other people.

The fact that ACT treats negative thinking patterns based on conditioning is
essential because it shows us how our thoughts are not as permanent or
"true" as we may think.

ACT has also been used as a therapy for post-traumatic stress disorder
(PTSD). ACT has shown success in treating PTSD by helping clients to
understand their thoughts and behaviors better, recognize and accept their
fears, identify the meaning of what happened in their traumatic events and
learn how to respond well to stressful situations. ACT has also been shown
to be as effective in only one hour of treatment sessions as in 20-hour
sessions.

The Four Principles of ACT

1. Acceptance

This principle teaches people to accept the thought, emotion, or behavior

they are currently experiencing instead of fighting it or making it go away.
In addition, this leads the person to experience their thoughts, emotions,
and behaviors in an anon-judgmental way, without trying to change or
escape from them.

2. Presence

Presence is centered on being mindful and present in every moment as

much as possible through accepting what is happening and not focusing on
the past or future. This helps people engage with their experiences more
thoroughly and helps them find meaning in those experiences.

3. Values-based action
This principle is used in conjunction with the other guides to help people
engage in behaviors consistent with the values and beliefs necessary to
them. ACT teaches people how to self-regulate by identifying their values
and how they can live a valued life. This helps people accept themselves as
they are and make better choices about how to behave in their lives, as well
as assisting them in better understanding their relationships between
values and chosen actions.

4. Acceptance and Commitment Therapy

ACT uses this acceptance principle, followed by a committee process that

involves making daily commitments to act according to those commitments.
This helps the client stay focused on the present and make choices that
align with their values instead of just fighting how they feel or trying to
make it go away.

ACT is mainly used as an approach for depression, substance abuse, and

PTSD. This is because these three conditions are the subject of research
that has shown ACT to reduce symptoms effectively. However, ACT can also
be used for anxiety, stress, and any condition brought about by negative
thought patterns, such as low self-esteem and negative self-talk.

Acceptance and commitment therapy (ACT) focuses on helping people

accept their emotions, thoughts, and behaviors at the moment instead of
fighting anything or wishing it would go away. Studies have shown that ACT
has been effective in helping clients to create new ways of thinking, which
leads to them being less depressed. They also found that learners showed
improvement in their symptoms of depression, with 94% showing a
significant reduction in their symptoms after treatment.

Similarly, studies have also shown that ACT is effective in reducing

symptoms of PTSD. However, PTSD makes it difficult for people who have
experienced trauma to make sense of their experiences and get beyond the
traumatic memory. Although people can learn a lot about what happened to
them through ACT, it is not yet clear how this might reduce the effects of
PTSD on an individual's life.

ACT can be used for many other conditions besides depression and post-
traumatic stress disorder. For example, people with eating disorders have
found success with ACT and have been able to overcome many obstacles
that had previously prevented them from getting better. The antithesis of
acceptance for people suffering from eating disorders is the need for
control. By learning to accept the way, they feel in the moment, even if it is
uncomfortable or painful, they can let go of that need for control and begin
healing.

ACT has been found to be as effective as other therapy approaches to treat

anxiety. ACT reduces anxiety symptoms by teaching clients about their
thoughts and feelings, identifying underlying concerns about those
thoughts, and being aware of triggers for anxiety symptoms. ACT has also
been used as a treatment for anxiety disorders and symptoms of PTSD.

Studies have shown that ACT produces similar outcomes to CBT by focusing
on people's thinking. In addition, studies have found that ACT is as effective
as CBT in treating depression and better than CBT at reducing anxiety
symptoms. ACT has also been shown to be an effective treatment for
substance abuse. For people with co-occurring depression and substance
abuse, there are "complementary" benefits, with both treatments working
together to get the most use of each therapy approach.

ACT is a relatively new form of therapy, developed in the 1980s, so more

research needs to be done about its effectiveness for other conditions and
long-term results.

There are no specific conditions that ACT should not be used for. However,
there are some limitations to the treatment. For example, in studying the
effectiveness of ACT for PTSD, researchers found that it is helpful for
people who have had mild to moderate PTSD symptoms to improve their
symptoms. However, for people with severe PTSD, ACT did not prove as
effective. This could be because severe PTSD is more debilitating than other
types of anxiety disorders and has many different causes that require
specific treatment plans.

ACT was developed to treat clients with "widespread pain" – negative

thoughts and emotions that significantly impact a person's life. This
includes the symptoms of depression, anxiety, stress, and substance abuse.
As such, ACT is less effective for people with a personality disorder.
However, this does not rule out the possibility that ACT will work for those
individuals. For those clients, therapists can consult with a psychologist
who specializes in personality disorders to determine if this therapy would
be helpful for that client. Research has shown that ACT is effective in
reducing symptoms of depression and PTSD and can be used as an
alternative treatment to CBT and other therapies used to treat these
conditions.

What makes ACT different from CBT

Acceptance and Commitment Therapy is a type of psychotherapy that
focuses on acceptance, mindfulness, and values-based decision-making.
Steven Hayes developed it in the 1980s. ACT has many similarities with
Cognitive Behavioural Therapy but also includes skills from Gestalt therapy,
Transactional Analysis, and Dialectical Behavioural Therapy.

ACT is based on the belief that emotional pain derives from a lack of
acceptance of reality and is often directly connected to past experiences.
People learn to accept their situation in the present by becoming more
objective about it, thereby managing their emotions. Acceptance is based
upon a shift from control to awareness. One can experience different ways
of being present, including being detached from pain (as in mindfulness),
separated from issues that create suffering (as in values clarification), and
open to change (as in acceptance); each way implies an acceptance
experience. Acceptance may be combined with value clarification
techniques depending on the client's needs, goals, and resources.

ACT provides a method of self-discovery that enables the client to increase

their level of personal responsibility. By accepting the present, a client can
develop more willpower, self-esteem, and positive emotion, thus preventing
negative moods such as anger or depression.

ACT is based on acceptance, choice, and values. ACT emphasizes that

people often have a limited amount of control over their lives and that they
are ultimately responsible for their problems. Therefore, individuals should
seek to develop greater personal power by accepting the past experiences
that have led them to be where they are today (past events), clarifying their
values around what is essential (choices), and taking action in line with
those choices (values).

The goal is to develop the skills to "act" and "not react" in line with one's
values and create a more satisfying life for the individual. ACT also
emphasizes the importance of "having a life worth living." In other words,
the goal is to live a meaningful and purposeful life.

ACT is considered an "experiential therapy," meaning it focuses on the

present moment. Unlike Cognitive Behavioral Therapy, ACT does not use
homework. Instead, it aims to focus on "here-and-now" issues and use
mindfulness skills during therapy sessions to prevent automatic thoughts
from taking over.

ACT is based on acceptance and mindfulness as an alternative to more

traditional forms of CBT, which may be seen as too directive by clients. ACT
does not administer direct advice to clients, as is common in CBT, but
rather provides a resource for clients to learn more about themselves. The
goal of ACT is to develop a more accepting attitude towards behavior and
emotions that may be experienced. By being open to these experiences and
observing them with greater awareness, individuals can commit fully and
freely to whatever activity they are undertaking.

ACT also emphasizes committed action, which means doing what is

essential to the person in the context of their values instead of intense inner
struggle about whether or not to do it.

ACT treats several conditions, including chronic pain, anxiety disorders,

depression, and substance abuse. ACT is also effective in treating stress and
burnout. A recent meta-analysis concluded that ACT was significantly more
effective than control groups on various measures.

Acceptance and Commitment Therapy has also been used to treat chronic
pain. A 2006 study demonstrated that Acceptance and Commitment
Therapy was a promising treatment for chronic pain. In this study, patients
were randomly assigned to 12 weekly sessions of either Acceptance and
Commitment Therapy or Cognitive Behavioral Therapy for Chronic Pain.
This study showed that Acceptance and Commitment Therapy resulted in
significantly more significant reductions in pain-related emotional distress
when compared to those who received Cognitive Behavioral Therapy for
Chronic Pain. The authors concluded that treatment based on acceptance
effectively reduces emotional distress while increasing clients' engagement
in meaningful activities associated with their values.

Cognitive-behavioral therapy (CBT) is a well-established posttraumatic

stress disorder (PTSD) treatment. CBT was first developed as a treatment
focused on the past. But researchers now know that focusing on history is
not as effective as focusing on the present. The theory of ACT suggests that
negative emotions and troubling psychological problems are caused by
people's attempts to control things in their lives that they cannot control.
They experience these attempts to retain as stressful, and managing leads
to emotional pain. The goal of ACT, therefore, is not to control anything but
rather to face what exists in the present moment and make peace with it.
ACT theory suggests that people can make peace with themselves in the
present through acceptance.

CBT focuses on changing thoughts, but ACT does not focus on how someone
thinks about things. CBT focuses on how a person feels about things, but
ACT does not focus on what a person thinks or feels. CBT emphasizes the
"circumstances" of the patient's problems, which is the source of their
suffering. But one of the aims of ACT is to develop an attitude toward
present circumstances that has value to the individual. For example, if
someone experiences stress in their life at work, an ACT therapist might
help them find new meaning in their job by helping them clarify their values
and commitments in this context. ACT emphasizes the importance of
committed action, a conscious choice to do what is essential to the person.
CBT focuses on the present moment and makes cognitive changes to keep
people in control, while ACT focuses on committed action and values.

CBT uses a more direct approach to solving problems. CBT therapists

believe that clients must figure out what happened in their past, even if they
will not be able to change it, so they can "figure out" how to live their lives
appropriately. They believe that people have a responsibility for their
behavior and emotions and must take responsibility for them. ACT
therapists use minimal conversation regarding how clients were raised or
how they are responsible for their lives' problems that may be difficult to
overcome. They believe that working toward behavioral change will help
people feel better and that changing thoughts or feelings can only result in
increased suffering. ACT does not believe that a lack of willpower causes
symptoms caused by unconscious beliefs about oneself. In other words, it
does not matter if a person has poor self-control if that person's
unconscious thoughts lead to poor behavior and pain.

ACT also emphasizes learning more about what values are essential to the
person, which is why it is necessary to clarify one's values before embarking
on any treatment plan. If a person does not know what is truly important to
them and does not know their values, then it is doubtful that the therapist
will be able to provide the treatment plan that the person needs to improve.
On the other hand, if a person knows precisely what their values are and
how they can best be used in conjunction with one another, then it is more
likely that they will be able to move forward with their therapy goals.

ACT treatment focuses less on changing people's thoughts and feelings but
on changing how they feel about themselves. In this way, people become
more accepting of who they are as they grow and change as adults. ACT
focuses on growing and what a person can do in life. It is often said that
acceptance of who you are at this moment is the first step to change.

ACT treatment does not use the same methods as CBT because the two
therapies do not focus on the same things. While CBT focuses on changing
thoughts and feelings, ACT focuses on changing behavior and helping
people develop meaningful lives by clarifying their values and making
commitments based on those values. The goals of ACT and CBT also differ,
which results in different therapeutic approaches. CBT focuses on the past
to change the present, while ACT focuses on the present and on who a
person wants to be in the future.

CBT is most effective when working with more specific symptoms. ACT is
most effective when working with broad lifestyle changes. CBT helps people
develop more positive behaviors and attitudes. In contrast, ACT helps
people improve their lives by improving their relationships with others,
increasing their feelings of acceptance of themselves, and helping them be
more creative in finding solutions to problems they face in life.
ACT emphasizes acceptance of thoughts as they occur, but acceptance and
surrender do not mean passivity or giving up. For example, a therapist who
uses ACT might encourage a client to change their behavior and take action
rather than waiting for external conditions to change. It is possible for the
person to accept the situation but at the same time work toward changing it
so that they may feel better.

ACT works best in people over 40 and who have experienced many losses
and disappointments in their lives. It is best used by people who have
become frustrated with CBT treatment, which focuses on past events. The
goal of ACT is to help a person come to peace with their life and find
enjoyment in it, rather than trying to live up to unrealistic expectations of
how life should be or should have been. A person frustrated with their past
will not be able to make meaningful changes in their life.

The present-centered therapy of ACT helps people make decisions based on

their values rather than the circumstances surrounding them. It allows
people to accept who they are without changing anything about themselves.
ACT teaches you how to experience life fully and find meaning in your
experiences rather than trying to avoid or change your thoughts and
feelings.

ACT helps clients learn how to live a whole life regardless of adverse
situations. This type of therapy is most effective when working with
depression and anxiety. CBT focuses on acceptance, but it does so in terms
of thoughts and feelings rather than behaviors and actions toward others.

ACT focuses on present moment problems and changes actions based on

those thoughts, while DBT focuses on the person's current situation and
plans to help them manage their problems. ACT helps a person accept their
ideas as they come, while DBT helps a person change their thinking.

ACT is more passive in its approach to changing the client's thought

patterns to manage pain. DBT is more active and encourages clients to step
forward and face their feelings head-on before learning how to manage
them effectively.

The goals of ACT are very different than those of DBT, which diverges from
ACT in the treatments offered. For example, ACT focuses on the client's
feelings of well-being, while DBT is focused on helping the client avoid
situations that result in negative emotions.

ACT wants the client to be present with those thoughts and to accept them
regardless of their content, while DBT encourages clients to change their
ideas to improve their lives. ACT uses acceptance as a means for moving
forward with life and managing pain, whereas DBT uses acceptance to
control anger, improve relationships, and increase self-respect.

The link between ACT, CBT, and DBT

In this chapter, we will discuss the connection between Acceptance and
Commitment Therapy (ACT), Cognitive Behavior Therapy (CBT), and
Dialectical Behavior therapy (DBT). The theory behind these three therapies
is to help people learn how to accept the things they cannot control while
committing to actions that serve their well-being. Although CBT and DBT
have different goals and applications, all 3 share the primary mechanisms of
behavioral change: Exposure and Acceptance, Mindfulness, and Value-
based living.

These therapies are used as interventions for a variety of psychological

disorders. ACT effectively treats depression, anxiety disorders, chronic pain
and other physical ailments, addictions and substance abuse issues, anger
and aggression problems, borderline personality disorder (BPD), post-
traumatic stress disorder (PTSD), and burnout. CBT focuses on helping
people cope with emotional issues by identifying negative thoughts and
replacing them with positive ones. CBT treats problems like depression,
anxiety, grief, loss, eating disorders, pain management, addictions, and
more. Marsha Linehan developed DBT to help people with Borderline
Personality Disorder (BPD) cope with their emotional problems.

The three therapies also share similarities in the way they function. ACT
and CBT are primarily goal-directed, while DBT emphasizes acceptance of
the patient's current situation. All three use methods of exposure therapy,
which involve exposing the patient to a condition that causes their suffering
to help them decrease their fear of the situation and change their reactions
to it. They also use mindfulness techniques which involve concentrating on
what is happening in the present moment without judging or evaluating that
information. Mindfulness helps patients see things as they indeed are.
Finally, all three therapies focus on helping the patient develop a set of
values or what is most important to them. These values can help guide
choices and decisions that lead the patient toward their long-term goals.

ACT has been shown in clinical trials to be effective in treating anxiety,

depression, and chronic pain on par with other behavioral interventions like
CBT and DBT. ACT focuses on teaching patients acceptance of painful
experiences in their present moment while also helping them commit to
valued behaviors that can better their life. The therapy starts with exploring
the client's current reality and the resulting values these create. This allows
them to identify which values are essential and make deliberate choices for
the positives that come from the negatives. ACT looks to create a
therapeutic environment where patients can accept the present moment
without trying to control it.

Cognitive Behavior Therapy (CBT) is a behavioral intervention used to treat

depression, anxiety, anger, and other emotional disorders. CBT is designed
to help people see how they perceive negative events and how this
perception affects their feelings and actions. In the later phases of CBT,
patients are taught methods of changing their thoughts to change how they
feel. These thoughts can be negative or positive depending on the context
and can be identified as realistic or unrealistic.

Definition of ACT, CBT, and DBT

Understanding how these therapies differ helps to understand what they

are. Acceptance and Commitment Therapy (ACT), Cognitive Behavior
Therapy (CBT), and Dialectical Behavioral Therapy (DBT) all fall under the
umbrella of behavioral therapies. These therapy methods involve exposing a
patient to their negative emotions, thoughts, and behaviors to help them
accept the present moment as it is while committing to healthier behaviors.
These may be behavioral or cognitive challenges that can be defined as
difficult but not impossible to complete. By practicing these three therapies
over time, patients can learn more about themselves and their behaviors
and identify new ways of reacting to situations that allow them to act more
positively toward themselves, others, and life.
Now that you know that ACT, CBT, and DBT are all related to behavioral
and cognitive therapies, it is essential to discuss how they differ. The first
similarity these therapies have is the goal they share: to help the patient
learn how to live more positively with the negative events or experiences in
life. This goal is the only treatment-specific element in each of these
therapies. The techniques used by each treatment are different but equally
effective when properly applied. A therapist can use many methods, but if
there is no goal for achieving change, changing behavior towards positive
action will not succeed.

ACT and CBT involve using behavioral approaches to help the patient
develop a set of values they can live by while simultaneously addressing any
mental or physical problems they face to help them achieve those values.
This means that the therapist needs to take a non-judgmental approach with
each patient to correctly select which therapist's techniques will work best
for that patient.

CBT is similar to ACT in this way. However, CBT uses cognitive and
behavioral techniques to help patients identify negative thoughts like "I
don't deserve this" or "This is horrible. How could they do this to me?"
Then, they are taught to replace these thoughts with positive ones. CBT's
non-judgmental approach means that the therapist is not allowed to tell
patients what they should think. Instead, the therapist works with each
patient to help them make more conscious decisions about how they react
and behave while also choosing behaviors that bring only positive feelings.

DBT differs from ACT and CBT in its focus on treating trauma and related
disorders, such as PTSD (post-traumatic stress disorder) and borderline
personality disorder (BPD). It is primarily designed to help patients with
these disorders identify and express their feelings healthily. This can be
done by following a set of guidelines, including being aware of the present
moment, staying in contact with their body, and maintaining mental
flexibility. These guidelines help patients act in a positive way that is
aligned with their values rather than reacting to situations with behaviors
that are unhealthy.

DBT does not involve traditional psychoanalytic therapy but action-oriented

treatment approaches such as exposure therapy, cognitive restructuring,
and emotion regulation training. This means it may be more time-
consuming than conventional psychoanalytic treatments, which include
more verbal sharing of thoughts and feelings. In addition, to be effective
with patients with trauma disorders, DBT must focus on helping them
behave differently than they did during the traumatic event(s). Therefore,
DBT does not focus on the patient's past and instead looks to move them
forward.

DBT was initially developed to treat borderline personality disorder and has
since been adapted from its original format by researchers and clinicians.
The most notable adaptation is mindfulness-based DBT or M-DBT, which
includes a component of mindfulness training. Mindfulness is a specific
form of meditation used in CBT treatments. In M-DBT, patients are taught
to notice their thoughts, feelings, and sensations without judgment. This
helps patients become aware of their emotions, ideas, and behaviors while
accepting them as part of themselves. This heightened awareness allows
patients to behave more positively towards themselves and others while
treating any underlying mental health conditions.

It is essential to recognize the differences between the behavioral theories

because they are used by different practitioners and may have other goals.
For example: while a therapist may use ACT in a social work or psychology
practice, CBT is usually done in more traditional primary care practices. As
such, the goal of each therapy will vary depending on how it has been
adapted for use by that therapist.

Cognitive Behavior Therapy (CBT) grew from the work of Albert Ellis and
Aaron Beck. Ellis developed Rational Emotive Behavior Therapy (REBT)
which is based on an individual's thoughts and how they interact with their
emotions. REBT was created to treat depression but has since been used for
many other emotional disorders like anxiety, phobias, panic attacks, and
substance abuse. In the 1940s, Beck expanded on this therapy, creating
Cognitive Therapy to treat depression by focusing on identifying negative
thoughts that led to negative actions. These two therapies eventually
evolved into what we know as Cognitive Behavioral Therapy (CBT). But CBT
was not the only therapy that grew out of these early works.

General Discussion about ACT, CBT, and DBT

As previously stated, ACT, CBT, and DBT all work to accomplish the same
goal of helping patients achieve mental and emotional balance. However,
the therapeutic techniques and plans are different for each. ACT focuses on
developing a core set of values while identifying one's emotions and how
they affect behavior during stressful times. CBT focuses on changing
negative thoughts or beliefs into positive ones while identifying faulty
cognitive processes contributing to these negative thoughts. DBT works
with trauma disorders like BPD or PTSD by helping patients become more
aware of their thought processes, emotions, and behaviors. To accomplish
this goal, DBT will use mindfulness techniques to help patients recognize
when they are being triggered and how these trigger responses affect their
behavior.

ACT, CBT, and DBT also differ in the techniques they use. ACT is based on
the philosophy that people should be aware of their feelings while
simultaneously being aware of their present moment surroundings (action
orientation). It focuses on teaching patients to develop their core values and
use this information to direct how they respond to situations. As such, ACT
focuses on helping patients identify and express feelings healthfully. This
can be done through anxiety-reducing techniques like breathing exercises
or learning cognitive techniques like focusing on positive thoughts rather
than negative assumptions.

CBT is primarily used for patients with anxiety disorders or depression. CBT
focuses on helping patients change their negative thinking patterns and
beliefs into positive ones. However, this is not a magical process and must
be maintained over time. CBT will also teach how these thoughts affect
moods, behaviors, and emotions. To do this, the therapist will work with the
patient to identify negative thought patterns and how they affect emotions,
behaviors, and moods. Once this is done, the therapist will help the patient
learn new ways of thinking that can lead to positive feelings like happiness
or contentment. CBT may include exposure therapy (a behavioral
treatment) to help patients face their fears, even though it does not focus
directly on doing so as DBT does.

DBT is similar to ACT in that it focuses on an individual's core values but

with a very different emphasis. DBT is designed to help patients with
trauma disorders, like PTSD or BPD, become more aware of how their
environments affect their thoughts, feelings, and behaviors. It also teaches
patients to respond to situations differently than they did during the
traumatic event. DBT teaches patients how to regulate their emotions and
develop healthy coping strategies to manage the effects of these traumatic
events better.

DBT was initially developed as a therapy for borderline personality disorder

(BPD) but has since been adapted by researchers and clinicians in other
mental health fields.

Determining which therapy will be most effective depends on what you try
to accomplish with treatment. For example, suppose you need emotional
support or guidance through a rough time in your life. In that case, all three
therapies can be effective since they provide non-judgmental advice through
difficult situations. Suppose, on the other hand, suppose a specific mental
health condition (like depression or anxiety). In that case, it is best to seek
out a therapist who has experience using any of these therapies with
patients who share that diagnosis. As stated previously, these therapies are
not the same and can be effective for different goals.

If you are interested in learning more about how one of these therapies can
benefit you, it is best to consult with a therapist who has experience using
one. An efficient way to find a qualified therapist is by using a phone book
or asking your primary care provider for recommendations.

How to develop willingness and acceptance

Willingness is a decision to act and is described as a will to do. Conversely,
Acceptance is the acknowledgment of what is, characterized by recognizing
that someone has no control over the situation. It is quite paradoxical that
people often want to live in a world free of suffering yet insist on being part
of it.

Willingness is a response to a challenge, whereas acceptance is a strategy

for coping with life. We've all heard that "willingness is what it takes to
make a will, and acceptance is what it takes to keep one." Both willingness
and acceptance are necessary if one is to achieve goals and resolve
conflicts, yet the relationship between the two is not very clear.
Will means to make a decision or to act. In the context of ACT, willingness
refers to the conscious decision "to initiate and persist in goal-directed
action despite obstacles."

For example, you might have the goal of finishing your thesis on time, but
due to illness or procrastination, you are unwilling or unable to do so. To
overcome this challenge with willingness is characterized by consciously
deciding to put aside personal preferences and needs (e.g., social
engagement, health) to accomplish your goal even if you're not feeling well.

One of the most frequent symptoms is "Willingness vs. Acceptance." It may

be the case that people want to work with a therapist, but they are not
willing to make any changes. On the other hand, it may also be the case that
people don't want to see a therapist at all. The latter example is often the
case for people experiencing intrusive thoughts due to trauma. They may
recognize that their behavior is not optimal, but they don't want to make
any changes. In such cases, willingness is lacking.

Acceptance refers to the conscious acceptance of reality, focusing on

feelings. For example, suppose you are unwilling to think about your mother
dying or contemplating how liberating it would be to quit your job. In that
case, you may experience discomfort with these thoughts, yet you may
accept that this is a healthy part of human existence.

Understanding the difference between willingness and acceptance

The first step in developing willingness is realizing there is a potential

conflict between those who want change and those who don't. This can
occur when one group wants to use therapy as part of their regular
treatment, and the other group doesn't think that therapy or treatment is
necessary or helpful.

The second step is realizing that a willingness to change must be nurtured

and supported through acceptance. Knowing something needs to change in
your life is not enough. You have to accept that something is going to
change, but it's up to you whether you want out of this situation or not.
In particular, accepting that you want therapy may mean accepting the
reality of your past experiences with anger and hostility, so they can
become part of who you are now rather than destructive parts of your past.

Acceptance also involves recognizing how good it feels (relaxation) and how
bad it feels (fear). Acceptance of negative emotions and thoughts allows you
to develop new behaviors that encourage acceptance when change is
wanted. For example, if you are willing to set a goal to quit smoking but are
not anxious about how hard it might be, this can help you align your will
with your actions.

Some research has also shown that acceptance of negative emotions and
thoughts is related to emotional well-being, whereas willingness to these
feelings was linked to emotional distress. Therefore, supporting people in
developing a willingness to face their problems or considering the
possibility of changing their lives may not always be the best strategy. For
example, one client reported that his wife often told him: "You should go out
more often; people will think you're antisocial.

In contrast, acceptance is characterized by the following symptoms:

Curiosity, trust, and humility are essential characteristics of acceptance. In
the case of a living situation with an abusive person (such as an alcoholic or
a person with an autism spectrum disorder), curiosity and trust can be
developed by exploring what it looks like to accept this type of person in
one's life without judging them. Humility is necessary because it ends all
judging, including self-judgment. When someone lives with such a person,
they realize that it is essential to be open, not to judge, and not to blame
oneself. It is positive in that it makes one see what is good in one's life, and
this attitude can lead to an awareness of the "real" problem.

Acceptance can enable a person to have a more useful life. This means that
acceptance helps people overcome their limitations and flourish.
Acceptance facilitates a more engaging, creative, and meaningful
relationship between self-concept and actual reality, as well as between
self-concept and other people. The quality of life within oneself will also be
apparent instead of being clouded by anxiety or frustration.
The process of achievement of acceptance within oneself goes in two
directions. On the one hand, they accept that their condition is fixed and
cannot change (acceptance as a kind of fatalism). On the other hand, they
accept to change their lives and make them better or change themselves
(acceptance as an attitude of willingness). The latter approach requires a
certain amount of courage, but it may determine a person's quality of life.

Willingness can also be developed in one's life. When people accept what
they are, they are willing to change themselves. This attitude is an essential
step in therapy and leads to a new beginning.

Two factors predict the individual's reaction to a problematic situation: (1)

pre-existing tendencies to react in a certain way and (2) potential for the
person to react differently. The first factor is called "a tendency," while the
second is called "potential."

When a person is confronted with an ambiguous situation, they tend to

determine which strategy will allow them to maximize their advantage and
generalize from this result. In cases where one's reactions are predictable,
the individual may be identified as having a particular personality type. For
example, suppose someone has no tendencies about what reaction to take to
various situations. In that case, they may be regarded as having no or an
average stable personality.

Predicting the reaction to a difficult situation is also important for

therapists. Therapists may find themselves in situations with little
information about a person's personality. However, even in such cases, it is
possible to catch an individual's tendency to react in a certain way. For
example, therapists can predict which patients are likely resistant or
compliant based on their characteristics.

It is essential to consider the following points:

1. Acceptance is not an act of resignation but courage.

2. Acceptance can be developed by considering one's situation as one would

if one had to live with the situation permanently.

3. People may not be prepared to change themselves, but they are prepared
to change their behavior and make it acceptable for others.
4. People often develop a sense of "false self" in difficult situations that can
prevent them from being honest with themselves and others.

5. Learning begins when people realize they have some control over their
lives (even if it is not much).

6. Difficult situations have the potential to cause great suffering, but the
ability to experience suffering is essential to achieve a greater sense of
truth.

An overview of factors associated with willingness has already been

presented in this book. Briefly, willingness can be described as follows:

These characteristics characterize willingness:

1. Readiness for change Worry about how others might judge oneself.
People who are not willing to change themselves often worry about how
others will respond if they make changes in their lives (e.g., how family
members might react if they change their behavior).

2. Ability to learn from experience People who are unwilling to change

themselves do not want to learn from their mistakes and are afraid of
making changes.

3. Ability to make decisions People who are unwilling to change themselves

often don't know how to decide what to do during difficult situations.

4. Ability for self-reflection People who are unwilling to change themselves

may have difficulty being aware of how they feel and think about a
particular situation.

5. Ability for empathy People who are unwilling to change themselves may
have difficulty recognizing what others think and feel during difficult
situations.

6. Ability to experience pain People who are unwilling to change themselves

may not be able to experience the pain that comes with a painful decision or
difficult situation.

7. Ability to act People who are unwilling to change themselves cannot act
and make changes in their lives.
8. Willingness is developed by becoming more aware of what one can
change in their life, the costs and benefits of any changes, and the
actualities that one accepts about oneself and other people: what one can
accept about their behavior, how one might react differently under
challenging situations, etc.

9. Willingness is developed through the process of willingness: the actual

decision to do something different and then making this new behavior a
permanent characteristic of oneself.

10. Success requires a person willing to make changes, a problematic

situation that can be made more manageable, and an environment that
allows for some change and growth.

11. Willingness is developed by having goals in life, being able to take risks,
being confident in one's abilities, and anticipating success.

Therefore, willingness and acceptance can be developed through:

a. Being willing to make changes in one's life.

b. Choosing goals and making them a part of oneself.

c. Having confidence in one's ability to find solutions and make decisions.

d. Understanding that one can only be successful if the environment

supports them.

e. Being aware of who, what, and where one is being successful and not
being successful at each step in life.

f. Developing a way of thinking that allows accepting difficulties

encountered along the way (acceptance as a kind of fatalism).

g. Having a way of life-based on confidence and preparation (pre-planning

in advance or pre-training).

Therefore, having the mind of a person who is willing to change and accept
would:

a. Readiness for change by understanding one's situation and acting

accordingly.
b. Ability to learn from experience by selecting accurately good situations
(and not insignificant difficulties) that can be mastered.

c. Ability to make decisions by anticipating situations that need to be

changed or adapted, assess the actuality of these situations, and choose a
strategy based on this thought process (e.g., what is best in terms of
success, reasonable compensation, etc.).

d. Ability for self-reflection by thinking about how one feels and what they
think about a particular situation during difficult times in life (e.g., what is
one is doing wrong?).

e. Ability for empathy by understanding other people's thoughts and

feelings during difficult situations (e.g., what happens when I lose my job?).

f. Ability to experience pain by recognizing that not everyone is happy in

difficult situations, but being able to decide what causes this and how one
wants to cope with it when the person is no longer there (i.e., accepting the
loss).

g. Ability for action by being able to implement changes that are useful or
necessary in the long run (e.g., making new friends so as not to feel lonely).

h. Willingness is developed by being reliable, having an optimistic attitude

towards others, and being a problem-solver (i.e., having the mind of a
person who is not lacking in confidence or abilities).

i. Willingness is developed by thinking more about what one can do rather

than what one cannot do and assessing situations in terms of actuality
without exaggerating.

j. The mind willing to change and accept can be developed by having a

positive attitude towards oneself, other people, and the world at large
(optimism).

k. The mind of a person who is willing to change and accept can be

developed by using strategies that are based on the way things are and not
on ideas that are based on romantic notions (e.g., thinking realistically)
l. The mind of a person willing to change and accept can be developed by
accepting that there are things one cannot do and does not want to do (e.g.,
giving up smoking).

How to help patients define their value directions

Acceptance and Commitment Therapy (ACT) is based on well-supported
psychological research in humanistic psychology, cognitive-behavioral
therapy, and behavioral medicine. This therapeutic approach is time
intensive and requires considerable skill to administer. However, ACT offers
therapists an efficient clinical tool that they can learn relatively quickly to
help patients define their value directions—what they want in their lives—
and create a plan for achieving those goals.

One of the core principles of ACT is based on valuing one's emotions as

opposed to suppressing or being consumed by them. Suppression of
emotions, significantly negative feelings such as fear, anger, sadness, and
shame, often leads to long-term distress. In addition, people will likely
emerge in other inappropriate contexts if they suppress these feelings.
Thus, it can be helpful for people with mood disorders to learn to
experience the full range of their emotions without acting on them or
suppressing them.

ACT therapists will typically ask their patients to create "values lists," which
help a person define their life goals and values. Then, the ACT therapist will
have the patient evaluate the degree to which these goals are based on each
of these values. For example, if someone values personal relationships, the
therapist would ask what assurance there is that people can be trusted and
can be counted on in different settings. In terms of money, what evidence
exists that money brings more happiness than sorrow? To the extent that a
goal cannot be supported by evidence, it is not likely to have much value for
the person concerned.

The ACT therapist will then ask the patient to identify the things that would
enable them to achieve these goals. For example, those who want financial
security in life might list some of their resources, such as savings and
investments.
Although this point sounds somewhat obvious, it is often overlooked.
Without being too technical, money can be thought of as a resource that
gives one particular opportunity of which one may not be aware should
come up in this way or at this time. In other words, one could have specific
opportunities they would be happy to experience at some particular time
without necessarily having any idea when or where they will appear.

The ACT therapist will then ask how important the patient considers each
resource to be. The patient may be asked to give a number, on a scale of 1-
10, indicating their importance. In this example, the patient might say that
savings and investments are an 8 (highest).

ACT therapists encourage patients to understand what they have done to

make successful changes in the past. They then ask them to evaluate
whether or not they have achieved any of their values in life or have made
any financial gains. If they have made such gains, some of their values were
likely being met at the time.

Therefore, the following tips can help patients define their value directions:

1. Encourage self-evaluation and goal setting

Self-evaluation is essential and can help people develop self-awareness. It is

also important to set goals that one can achieve. For example, suppose a
person values family relationships. In that case, they may achieve this
through setting up and maintaining a network of close friends, showing
kindness to their children and partners, or visiting their parents or siblings
regularly. Likewise, they may benefit from watching the stock market's
gains or managing an investment portfolio if they value money.

2. Prioritize values

Each individual has several core values in life. Each core value often points
to one or more overarching goals in life—one's "ultimate values. These
ultimate values may be expressed by words to the effect of "health, wealth,
love, and so on.

Importantly, patients are asked to rank their overarching goals in life

regarding their importance. So, for example, if someone values being
healthy and being wealthy as significant goals in life, they would ask
themselves: "What evidence is there that I am meeting both of these goals?"

3. Create an action plan

ACT therapists will encourage patients to create an action plan to achieve

their ultimate values by identifying specific outcomes or changes that would
enable them to achieve those goals. For example: "I will demonstrate
kindness and generosity toward my family this week. I will try to be more
caring and thoughtful toward my children." "I will work on improving my
fitness by exercising three times per week. I will also try some new recipes
this weekend to have more healthy meals available during the week."

The problem with asking patients to make specific changes in their lives is
that they may not know how to do this, especially if they are not used to
making specific changes. Therefore, ACT therapists often help them by
giving them examples of what the first step might be. For example, if
someone has a goal of being healthy and is overweight, the therapist might
suggest that they begin exercising by walking for 20 minutes after dinner
each night. If a person wants to be wealthy, the therapist might suggest
that they start saving and investing monthly money.

4. Give these steps some time

ACT therapists will encourage patients to be patient with themselves and

not get too frustrated if they do not achieve their ultimate values or goals
straight away. Doing essential things in life takes time and a lot of practice.
In this sense, moving toward your goals often involves "baby steps" or "baby
steps" forward that are each small enough for people to accomplish them
without feeling overwhelmed.

The mindfulness aspect of ACT, which is present in most forms of CBT,

contributes to general awareness development; thus, it can help people
notice how they feel while moving toward their values. However, some
people have difficulty identifying or describing their feelings. In these cases,
an ACT therapist might encourage them to use a rating scale (for example,
from 0-10) to rate how they feel throughout the week. This can help patients
become more aware of their feelings and why they feel them.
5. Be flexible

ACT therapists are aware that, although many of our goals have been with
us for quite some time, they may sometimes need to be revisited, changed,
or refined. For example, if patients notice that they are not consistently
moving toward some of their core values, they may need to re-evaluate their
purpose in life by asking themselves: "What is important to me? What goals
can I achieve? What is the evidence that my life is moving in the direction I
want it to?" It is also essential for patients to remember that not achieving
one goal does not mean that other goals cannot be achieved if a person
stays committed to them.

ACT therapists usually encourage people with chronic illnesses or who have
experienced significant trauma in their lives (e.g., abuse) to work toward
achieving specific steps toward their core values. These include people who
have had the following conditions:

ACT aims to help patients develop self-acceptance and learn to value

themselves as they are, in the here and now, rather than pursue particular
values or goals that may or may not be attainable. This is based on the idea
that people often have many goals and values they want to achieve.
However, people sometimes hold onto these ideals without the hard work
needed. For example, people may say to themselves, "I want to be rich" or "I
want to be a good person," without recognizing that achieving these goals
requires specific actions.

Some people may have goals that are out of touch with their core values.
For example, it is unlikely that someone who values close relationships and
has few friends would pursue becoming a TV celebrity if it meant sacrificing
time spent with loved ones. ACT therapists will encourage patients to re-
evaluate their goals by first asking what the patient wants in life and then
helping them figure out ways to achieve those goals via concrete steps
toward them.

ACT therapists will not just ask patients to choose one or two goals and
work toward them. Instead, they will help patients to identify several goals
and work on achieving them in the short term. For example, suppose a
patient has identified several values (e.g., being wealthy and having good
health). In that case, an ACT therapist may encourage them to take small
steps toward achieving these goals each week or month (e.g., exercise more
frequently or invest part of their income into mutual funds). This way,
people can gradually move toward their ultimate values while not feeling
overwhelmed by trying to achieve everything at once. ACT advocates an
approach to therapy that includes getting people to develop a "coping life
philosophy" in which they try to live up to their core values.

ACT does not aim only to get people to change how they think about
themselves but also how they relate and behave with others. For example,
ACT therapists will often ask patients with significant problems like autism
or schizophrenia how they want other people in their life (e.g., family
members and friends who tend to be critical) to act toward them. "For
example, I may ask a patient, 'How can I start by being more accepting of
my family's behavior toward me? What are some things you can do in your
life that will help you to be more accepting of people?'" It is also true that
ACT therapists will encourage some people with chronic illnesses or
significant personal loss to work on acceptance.

In addition, someone trying to develop a core value like acceptance might

decide to ask family and friends how they want them to behave toward
them. In general, these gestures show patients how they might be able to
make genuine changes in their patterns of behavior and communication
with others. These changes might then help the patient to develop more
meaningful relationships in their life. However, ACT therapists usually
encourage patients to work on these issues one at a time rather than in
bulk.

Psychologists often describe emotions as being "felt" with certain

physiological sensations. For example, they may describe how anger is felt
with a tightening in the chest area, while sadness is accompanied by a
feeling of heaviness in the body. However, these associations are often not
conscious, which means that people do not know why they feel that way;
therefore, they have difficulty describing their feelings to others. Therefore,
ACT therapists will often ask patients to be more specific about their
feelings and why they feel them. This helps them be more aware of their
feelings and communicate them better to others.
ACT therapists are interested in helping patients develop a clearer
understanding of what they want from life, apart from the expectations of
other people or cultural stereotypes. They will help patients get in touch
with their values and find ways to achieve them.

How to clarify values and commit to valued-based actions

To clarify your values and commit to value-based actions, you must be
willing to accept your thoughts and feelings without dictating how they
should be. For example, if you are anxious about doing something because
you fear rejection, instead of fighting the feeling or trying not to feel
anxious, you must learn how to say "I am anxious" and "This makes me feel
this way." It can help us learn acceptance skills if we label our emotions as
they come up. Labeling your emotions when they first appear will help you
understand what triggers a particular emotion or feeling.

Value clarification is not just about learning how to identify your values but,
more importantly, how to hold value-based action simultaneously, and you
are learning acceptance skills. Value clarification is a process that allows us
to understand why we have goals, wants, and needs and what systems will
help us meet them. We must clarify our values with other people for them to
help us meet our valued goals.

For example, if you are involved in a group therapy group of people who
want to stop drinking, then it may be helpful for you and your therapist to
identify your values so that you know why it is important to stop drinking.
Your therapist may also be able to offer you different techniques to stop
drinking, such as Dr. Williburtons' model of continuing recovery.

Looking at your values will help you to clarify what goals and actions you
want to accomplish to meet those valued motivations. However, it may also
lead you to discover that your idealized self is buried in shame that has not
been addressed. This discovery can be scary and hard to accept, but it will
start a process for you where you begin the process of healing from the old
wound or fears which have come up around conducting new behaviors and
attaining your valued goals.

Moreover, commitment to value-based actions is the ability to do what is

essential and meaningful to you, even when it is difficult. For example, if
you are married and are trying to discuss essential relationship issues with
your partner, your partner does not seem willing to listen or talk about it.
Therefore, it may be helpful for you to commit to valued actions of
expressing how you feel about the issue, even though that action may not be
easy.

When we can hold our value-based actions and stay committed by saying
things like "I know this is hard, and I am still going to do it" or " I am
committed to, whatever happens, even if my spouse or significant other
doesn't change," then these become action statements that help us move
through a situation.

For example, if your therapist is trying to work with you to interpret your
values and actions and focus on a specific goal, then it will improve the
process if you state things like, "I know that this is hard for me to do, but I
still want to do this." This type of commitment helps us hold our valued
actions despite the difficulty.

Once we learn how to clarify our values and commit to value-based action
statements, we can begin learning "how" we will hold and express these
things. We must practice how we will operate in the world, for these new
skillsets or beliefs systemically function better in our brains. How we relate
to people and the world will change once we fully accept them, clarify our
worldview and choose value-based actions.

Acceptance and commitment therapy is a process with many steps to

complete the value clarification process. By learning to clarify your values,
learn how you want to act based on those values, commit to valued action
statements and practice these new behaviors, you can lead yourself out of
old patterns of behavior that were not using your newly learned skillsets.
Once you have completed this process, it will be possible for you or a client
that you are working with or helping them complete Steps 2- 10 in this
model.

Therefore, the following tips can guide on how to clarify values and commit
to valued-based actions:

1. Clarity to confusion
This works by learning to accept the confusion around our values,
worldviews, and actions. You will learn to allow yourself to see the picture
in your head or observe your current unconscious behavior patterns.

2. Seeing ourselves as different

This works by learning that we are different people than we think and
capable of doing new things than what was previously done in our life.
Realizing that what has been done before is not who we are today will begin
a healing process by seeing our old wounds in a new, more accepting way.

3. Being clear about your values

This works by learning to identify the essential things in your life and clarify
your values. This can be challenging as we do not always know what is good
for us or what we want for our lives, but this process is essential in
uncovering our true feelings and needs.

4. Seeing through different eyes

This works by learning that you have essential lessons from life and other
people, which will help you find new and better ways of relating with people
and the world around you.

5. Being able to accept all points of view

This works by learning to be clear about what you feel is right, wrong, or
indifferent without wanting to control anything or anyone else's behavior.
Seeing both sides of the situation helps you accept that our worldviews will
never be perfect, and it may be challenging to find the fine line between
accepting and adjusting.

6. Learning how to identify what matters

This work by learning to focus and keep your mind on acting in a

meaningful way and not being distracted by unimportant things, which will
help you in your daily life.

7. Learning how to commit yourself

This work by learning how to commit to your values, even when it is hard,
or something important comes up during the day.
8. Learning how to commit to valued-based actions

This work by learning how to say things like " I know this is hard, but I still
want to do this" or "I am committed to whatever happens, even if my spouse
or significant other doesn't change," which will create an action statement
that helps you stay focused and continue your valued goals even if it is
difficult.

9. Knowing what values you have

This work by learning the differences between different worldviews you

have and being able to articulate what morals, values, beliefs, and
principles are most important in your life so that you can make choices and
decisions in a way that feels true.

10. Learning how to accept and express your values

This works by learning how to accept and express your values daily. You
will learn how to create a meaningful and consistent life with who you are
so that you can operate out of a sense of yourself, others, and the world
around you.

Many people will have difficulty completing this process independently, as

they may not know where to start or have support from other people. If this
is true for someone you are working with, I would suggest they see a
counselor or therapist who can guide them through the steps and ask
questions if they need more help or insight into their life.

11. Learning how to define success

This work by learning how to clearly define and understand what is

meaningful in your life and how you want it to be. By learning what is
essential in your life, it will be easier for you to decide where you want to go
and who you want to be. For example, maybe learning what is essential will
help us know when we are wasting time on things that are not useful or
helping us achieve our desired goals.

12. Learning how to live with failure

This work by learning how to learn from failure and change your beliefs,
thinking and behavior in a way that will become more useful.
13. Learning how to express values

This work by learning what it means to be clear about what you want and
need in life. We will learn new skills like expressing ourselves more clearly
in everyday conversations, dreams, thoughts, and actions; this will help us
become more explicit about our ideas and beliefs so that we can say them
out loud without the fear of rejection or judgment from others.

14. Learning to listen to yourself

This works by learning to listen to what you need and want from people,
events, and the world around you. This will help us become more effective
in social situations and relationships, which can help us grow in our
personal and professional lives.

15. Learning how to forgive others

This work by learning that everyone does not always mean well or even
know the effect of what they do, so we will learn how to forgive people for
their mistakes or areas where they are wrong. This will allow us to focus on
what is 'real' or authentic about a person instead of letting our emotional
sides get in the way of rational thinking.

16. Learning how to forgive yourself

This work by learning to accept who you are and your limitations around
certain situations or people and not to blame yourself. This will help you
accept your faults in different areas of your life so that you can move on and
improve, rather than dwelling on things that happen in the past that we
cannot change.

17. Learning how to acknowledge yourself

This work by learning how to express ourselves more clearly in everyday

conversations, dreams, thoughts, and actions; can help us feel better about
what we have done in our lives, thus showing appreciation for who we are
today instead of wishing we were someone else or had a different life.

18. Learning how to be motivated to succeed

This work by learning how to create the beliefs, goals, and actions that will
help us feel motivated in daily life so that we can take care of ourselves and
make optimal choices. We will learn to develop self-confidence and higher
motivation levels, which can positively affect our lives.

19. Learning how to stay motivated

This works by learning to maintain motivation internally with discipline,

persistence, and consistency so that you can overcome your fears and
doubts when starting something new or changing old habits. You will learn
what does not work for you to commit more fully.

20. Learning how to make a vision for yourself

This works by learning to imagine, feel, and realize what you want and need
to bring these visions into life through positive action. It will help you
commit more fully to achieving your goals and dreams and break down any
barriers or obstacles on the road.

21. Learning how to create a vision for others

This works by learning to project our values onto others constructively

while not getting on their case all the time or trying to convert them. We
will learn how to help others be more aware of their values so they can
defend their ideas or stand up for themselves in a way that is consistent
with who they are.

22. Learning how to dream

This works by learning how to create the beliefs and goals we have always
wanted and how to convert our visions into life. This can help us know what
we want from our goals and dreams and feel more connected to other
people's dreams.

How to be present through mindfulness

ACCEPTANCE AND COMMITMENT THERAPY is a behavioral treatment for
problems such as depression, addiction, and anxiety disorders. It was
developed by Steven Hayes, Ph.D., and originated from the Buddhist
practice of mindfulness.

The core principle of ACT is that it is not what happens to us in life that
causes us to suffer emotionally but our thoughts about what occurs.
Therefore, ACT teaches skills to help people engage with the present
moment without judgment and with a quality of compassionate acceptance
towards oneself and others.

ACT uses different metaphors that emphasize this idea, including "radical
acceptance," "enlivening touch," and "what if it's a good thing.

The first step to taking control of your life and emotions is to be mindful.
There are many different definitions of mindfulness, but what they all have
in common is a focus on being present.

Mindfulness means being aware of the environment that you live in and the
people that you interact with daily. This allows you to take your reality
head-on and not judge it as good or bad, pleasant or unpleasant. It means
seeing things for what they are, without preconceived notions or judgments
of your own. It also means being aware of self, as well as other people.

Thoughts are just that: thoughts. They are not necessarily wrong or suitable
for you, but they come from a place of emotion and affect your ability to
think clearly throughout the day.

In mindfulness, a core belief is that all experiences are neutral as long as

your mental state is clear. Most importantly, though, is the idea that our
thoughts can be changed. When there is no judging involved in feelings and
experiences, it will be easier to accept them. This will allow you to focus on
the present moment with clarity of mind rather than on past hurt or
traumatic events that might still affect your present behavior and emotions.

To be mindful, you must engage in a three-step process:

a. notice

b. acknowledge

c. accept to create a space between you and your emotions that allows you
to live in the present moment instead of dwelling on the past or fearing the
future.

ACT seeks out, accepts, and embraces negative thoughts, emotions, and
physical sensations for what they are, without judgment. For this to work,
three things must occur: 1) noticing what is happening around you; 2)
accepting it without judgment; 3) committing yourself to positive action
despite all these things that might be going wrong in your life.

The ACT model is based on acceptance and commitment therapy, initially

developed for people with substance abuse problems. It treats various
conditions, including depression, anxiety disorders, chronic pain syndromes
(Somatic Experiencing), sexual addiction (Emotionally Focused Couples
Therapy), and impulsive behavior. It also helps to prevent relapse in
survivors of child abuse.

The last part of this process is the most important. When you can accept
things, your mind is no longer clouded by judgments and self-judgment. You
can then begin to notice the patterns that bring about negative thoughts
and emotions. You can then remove yourself from situations that cause
discomfort or stress and acknowledge that there are other paths to take.
You can then change your environment or life to match your acceptance of
yourself and others rather than being hard-pressed by a negative mindset or
influenced by others who may use words or actions to keep you in a state of
anxiety and despair.

ACCEPTANCE AND COMMITMENT THERAPY doesn't force you to deal

with difficult situations in a state of mindfulness. Instead, it gives you the
tools to walk away from negative situations to return to them later once you
have regained control of your mind and emotions.

However, some say that ACT is a series of techniques used to manipulate

people out of their comfort zone subtly. For example, that ACT manipulates
the client into accepting what ACT Therapists say as truth without
questioning. Critics also charge that this approach creates "a quasi-religious
rather than therapeutic experience for many patients."

Therefore, the following tips can guide how to be present through

mindfulness:

1. Accepting the present moment has to be a priority

We are often taught acceptance in therapy, but it is a skill that we rarely

practice. When you are busy planning your next move or worried about
what will happen next, you can't notice the moment you are in. Moreover,
criticism and self-judgment for being in the present moment cloud your
mind and prevent you from accepting what is happening, which leads to
suffering.

Consider eating, sitting, watching TV, taking a shower, or going to sleep as

opportunities to practice acceptance. Linger over the sensation of chewing
food or smelling a flower rather than cutting your meal short or walking
past that flower. If you have trouble sleeping at night, focus on your breath
and body rather than planning your day tomorrow.

2. Be aware of what is happening in your environment

Mindfulness can be difficult when we are in situations where we feel like an

outsider or when we are constantly bombarded with distractions. This can
be difficult for people who are very narrow-minded about their world.
However, something is always happening in our lives, so be present in those
moments, too.

Imagine you are a child at a birthday party and you don't know anyone
except one other child attending the party with his parents. You may feel
awkward being at the party, but it's not strange because there is plenty to
do that involves your imagination and creativity. Instead of having a wrong
time at the party (this can include being bored), try to get into the moment
and imagine what it would be like if everyone had fun together and you
were able to interact with them during the party.

3. Think about your reactions before you have them

When we get into unpleasant situations, we don't react in the best way
possible. For example, if a classmate is rude to you during class, instead of
reacting poorly by turning red and thinking that this person is terrible and
everyone hates them, think about the situation from their perspective. What
does this person see in you? Were they not included in the group for any
reason? If so, why? Instead of jumping to conclusions about what's wrong
with them, try to understand what's going on in her mind.

4. Learning which events you can control and which you cannot

Sometimes, we might feel frustrated when we get into stressful or awkward

situations. We might see our inability to control a situation as a fault;
however, this is not necessarily the case. First, ask yourself whether you
can change the situation at hand or if it's better to let it pass. Next, ask
yourself why you want to change it in the first place. Finally, let it go and
learn from your reactions if it's not a good reason. The more you learn about
how your reactions affect your behavior and emotions, the easier things will
be when they happen again.

5. Helping others

When you are in a situation, your attention will immediately be drawn

toward others experiencing distress or discomfort. You will want to help
that person, but you must be aware of your situation. Instead of comfort and
care, sometimes people want to be left alone because they need to think
through their feelings or overcome a fear or phobia. Moreover, you may
react poorly if someone else is also trying to help you. You might feel like
everyone is trying to change you instead of accepting who you are now.

If someone is trying to change your behavior or beliefs and make you

uncomfortable, stop and think about the situation. If you know nothing is
wrong with your actions, then let the person know how they are making you
feel. If it doesn't stop, walk away and return when you have a clear head.

6. Changing your thoughts about yourself

When we are at our best, we are accepting of others and ourselves. To get
to this point, it's vital to think differently about ourselves than we do when
things go wrong in our lives. When someone makes a mistake and beats
themselves up over it, look at the situation and determine whether it is
worth beating yourself up over. Ask yourself whether it is possible to make
a mistake without having something wrong with you. Think about what you
should tell this person and consider their feelings.

If the answer is no, then make a conscious decision to think differently

about yourself and others. For example, don't get angry or offended if
someone calls you a negative name or accuses you of doing something that
makes you look bad. Instead, try to understand why this person said that
sentence and think about why they would say it in the first place. When we
change our thoughts about ourselves, we can change how we view
ourselves to be more accepting of who we are now and how we feel in the
present moment.

7. If you are in a situation where you cannot control anything, accept this

Sometimes, we can't change a situation like last week's weather or a fight

with someone. This doesn't mean that it's not possible to let go of the
situation and be present in the moment. It might take practice, but it is
possible to be still and accepting of difficult times. Think about how you feel
when things aren't going your way and ask yourself whether letting go is
actually what you want to do.

Asking questions like this can help us determine whether something is

wrong with our thoughts. If we feel happy when things aren't going well and
can still make decisions, there is nothing wrong with us. We might feel like
something is wrong with us if we can't control our emotions, but this is not
true. It's possible to find comfort in situations where we think it isn't
possible.

8. Letting go of regrets

Sometimes we look back at something that happened in the past and regret
things that didn't go the way they should have. For example, we might miss
an opportunity because of a decision someone made or say something that
hurt someone's feelings or break up with someone who, deep down, we
know would be a great partner. If you think about the past, try to let go of
your regrets.

As much as possible, think about why you made that decision and what you
should have done to improve it. For example, if you broke up with someone
because they did something that hurt your feelings, ask yourself what they
were feeling at the time and if this was something meaningful or not. After
all, it is possible to see situations from two different perspectives and come
to two different conclusions about what happened.

9. Let go of your fears

Fear is always there, no matter what we do. Fear can be related to whether
someone will like us, what kind of job we might get when we graduate and
which people will like us. However, most of the time, fear is not a good
thing that our minds should control. Every time you find yourself
experiencing fear, ask yourself whether it's worth it to let it control you or if
you could do something to overcome it instead. The more you look at fear as
a positive feeling and investigate the reason behind your fear, the more
control you will have over it.

The only way to overcome fear is to keep trying. There are numerous things
we can do to control our fears, but the best way is not just to try to control
them but also to find a way to accept them as they are. Consider the
situation and figure out whether you could be afraid of something that isn't
that bad in the first place. You might also ask others who know what you're
feeling if they think there's a reason for your fear or if it isn't worth
worrying about.

How to help clients commit to act by setting goals

Acceptance and Commitment Therapy (ACT) is a form of cognitive
behavioral therapy that is particularly effective for individuals with a high
degree of avoidance. Individuals who commit to their goals are more likely
to reach their desired end or ultimate goal. Thus, setting the appropriate
goals before taking any action has led many people in those cases where
avoidance may be a factor in success (or lack thereof) in committing. The
ACT contains an extensive array of specific strategies. Still, the most well-
established ones include identifying and clarifying one's values and looking
at aspects of the self that may be holding back change or success. This is
done by using "the worksheet," a form in which goals are generated and
then revised over time to help people reach the goals that they set
themselves.

The worksheet can be used in different ways to approach goal setting, such
as:

a. Identifying Desired Characteristics and then Experiencing Them

b. Asking About the Future and then Evaluating Actions/Behaviors.

It has been said that ACT is more than just an effective way of helping
someone commit to change, but a "way of life" taught to help people live
better lives. ACT recognizes that many people are not the way they would
like. Therefore, rather than the negatives, it focuses on the positives and
how one can get there through setting goals and observing their progress.

ACT uses a variety of different exercises to help individuals reach their

goals by following a series of steps, such as:

a. Identifying Goals

b. Setting these Goals

c. Focusing on the Values/Beliefs that are Important to the Person

d. Estimating How One Would Feel if They Reaching Those Goals.

b. Experiencing Those Desired Feelings by Using Helpful Methods

c. Instilling a Sense of Direction

d. Applying Exercises from Session to Daily Life, e. Learning how to Accept

and Commit

Clients who struggle with setting goals may find it helpful to identify their
values to help them determine what they want out of life. Removing the
word "should" from clients' vocabulary can also help them to change their
outlook on the future and their goals, as well as help them anticipate what
they would feel like if they managed to reach that goal.

Studies have shown that values help individuals identify specific goals worth
setting and are likely to be valued by them and not just by others. In
addition, it has been found that individuals who believe in their values are
more likely to follow through with a goal when there is no outside pressure
involved in the process.

When looking at the process of setting goals and having a sense of direction
towards them, it is helpful for the client to have a journal. Having a journal
allows the client to keep track of their experiences and feelings that may
arise for them to develop more in-depth self-awareness. Through journaling,
it is often recommended that clients practice their "negative visualization"
to help them identify what they do not want while recognizing what they do
want. This specific exercise helps the individual by helping them to see the
adverse outcomes of not reaching those goals.
Therefore, these tips can guide how to help clients commit to act by setting
goals:

1. Identify the client’s distressing thoughts or problem

Distress identity refers to the identity one has for themselves, their "who I
am." The term is used to show how even though that person may experience
other people's verbal or physical abuse, they do not feel they belong to that
group. In addition, this identity can help identify what the client does not
want to be identified with, for example: "I am a very accepting person" and
"I do not like being judged."

2. Identify the client’s distressing feelings

Distress feelings refer to the emotions and sensations from experiencing

distressing thoughts or problems. When considering distressing feelings,
they often have a solid emotional connection attached. For example, "I am
worried about the future" versus "I am worried about being a burden."

3. Identify the underlying desire that is being thwarted by the thought or

problem

The underlying desire is most likely the opposite of the distressing feeling
that the client has, such as "worrying." This term refers to how clients view
themselves concerning other people. The underlying desire may be "I am a
good person."

4. Help the client identify a specific workable goal

The goal must be within the client’s life and be significant enough so that it
will matter to them daily. When there is no specific goal, distressing
thoughts continue to haunt the individual or cause further disturbances in
mind. "Other people will always judge me" can become "I am a good
person," which leads to more positive feelings.

5. Have the client estimate how they would feel if they reached their goal

There must be an emotional attachment to something deemed necessary to

reach, such as a goal that may be money-related. For example, "I will feel
confident" versus "I will be a good person" allows for more positive feelings.

6. Help the client experience the desired feelings by using helpful methods
Once the client states the goal and estimates how they would feel if they
reached it, ways of reaching that goal should be outlined. Clients must then
write about their goals daily to encourage them to take action (specificity).
The client can set daily reminders such as alarms or call friends and family
to remind them of their goals. Also, setting goals helps individuals become
more aware of what they do not want rather than what they do want
because it is essential to recognize how one feels when they are
unsuccessful.

7. Encourage the client to participate in an ongoing process of self-

awareness

The final step is to help the individual become more aware of how they are
progressing and what they are doing to make progress. Once this
awareness is reached, the individual can be confident that they are not
getting back on track and can accept themselves for who they are now.

8. Help the client identify a means to improve and adjust their long-term
goals

The goal should not be something that one thinks they will "do" or "be," but
it should be something that one believes they can choose to do or be, such
as "to earn an advanced degree in a certain area.”

9. Have the client apply these techniques to their daily life

The suggestions in this book can be helpful for anyone struggling with
setting significant goals and motivating them to take action. This book will
teach readers how to help clients identify distressing thoughts and
problems and how distress is experienced using helpful methods. This book
will focus on teaching them how to reach their goals and apply them to daily
life so that they do not get distracted once they have made progress. This
book suggests that having a journal will be helpful for clients and
identifying one’s values, which are personally significant enough to create a
positive change in the individual’s life. Therefore, the book can be helpful to
those who are interested in helping others set their goals and reach them.

10. Provide encouragement and support in reaching that goal

Having a support system can help someone who struggles with setting
goals. By allowing them to address issues and concerns in a safe place,
clients will be able to feel more comfortable and confident about reaching
their goals.

11. Help the client identify a relapse warning sign

Sometimes when one reaches one goal, other issues are difficult to
recognize and address. Therefore, it is essential to identify if there are any
warning signs that the client may observe themselves experiencing. When
one is aware of these warning signs, action can be taken immediately before
they have a chance to fall back into old habits again.

12. Help the client identify a method of preventing a relapse

When individuals reach one goal, they may feel satisfied and as if they do
not need to work towards anything else in the future. Therefore, it is
important to identify methods that will encourage them to continue putting
in effort towards their goals. These methods can be different for each
individual and should be considered accordingly.

13. Encourage the client to ask for help when needed

Setting goals can be challenging, especially if the individual is experiencing

difficulties or is distracted by other outside factors, such as other people’s
negative comments or behaviors. When one is exhibiting these warning
signs and starts to experience symptoms of relapse, it is best to seek help
because they are experiencing a significant problem and cannot handle it
independently.

14. Have the client recognize their strengths

The strength of someone is an essential factor in setting significant goals.

When one has these strengths, one can commit to a goal and stay
committed.

15. Have the client identify their challenges

To reach an important goal, it is essential to identify the challenges in one’s

life. One may face these challenges and be unwilling or unable to change
their current condition because they believe it is who they are or will
continue being this way forever. It is best when they think that there is no
alternative or that there is no other solution besides their current situation
—it will not change.

16. Help the client identify past and current challenges

When facing challenges, examining past and current problems can be

helpful. Past problems may be attributed to previous adverse events.
Examining these issues allows individuals to recognize their failures and
develop new coping strategies. Current problems can relate to obstacles
unique to the individual’s daily life, such as relationship issues or work
stress. This allows them to recognize difficulties and work on improving
their situation while still having a choice.

17. Have the client identify their goals for themselves personally

One can think about their strengths and identify those that are personally
significant, whereas one can think about their challenges and allow them to
have personal significance. One may have difficulties with one of these two
factors but no problem with the other. As a result, they can better identify
how they can progress towards significant goals because they do not have a
problem with one area, making it challenging to work on the other aspect.

18. Help the client identify ways to influence others

When one is trying to influence other people, they experience trauma.

Therefore, it is essential to have a plan before taking action. When one gets
upset or frustrated while trying to help others, they may experience
difficulties and frustration. Therefore, it is best to have a concrete plan
before taking action and prepare them beforehand with different ways that
they can inspire and encourage them through their actions. This will
prevent either side from getting frustrated quickly and allow the individual
to work on their personal goals while they can use the previous methods on
others once more.

How to stop intrusive and obsessive thoughts

One of the most common challenges people face with anxiety is intrusive
and obsessive thoughts. These thoughts may take many forms but are often
unpleasant, repetitive, and distressing.
Expert opinion is that these are a form of mental activity called worry or
rumination, and they can be closely linked to an individual's feelings of
worry or self-doubt. Indeed, research has shown that people with OCD often
have above-average levels of worrying about everyday issues in their lives.

To overcome intrusive and obsessive thoughts, we need to break the link

between worrying or rumination in the case of OCD and these thoughts.
This is the first step in developing new, more helpful ways to tackle
unwanted thoughts.

Step 1: Decide what makes you worry a lot.

What does it mean for someone with persistent intrusive thoughts to 'worry
a lot? To answer this, it is necessary to understand what it means for you.
For many people with anxiety, worrying a lot means spending some time
thinking about something before they go to sleep at night. It may mean
being unable to settle on one topic in conversation with another person or
having repetitive images run through their head during the day.

Often we do not like thinking about ourselves and how we feel. As a result,
we may avoid thinking about what is bothering us, which often leads to
anxiety or worry. If you find it difficult to think about yourself positively or
take the time to evaluate what is worrying you, then it might be because
you care too much or are simply unwilling to think about how you feel.

If this is the case, it may be useful to consider whether sometimes worrying

a lot is healthy and, as they say in Eastern culture, "When in doubt - leave it
out." While sometimes worrying can be helpful (for example, when facing a
tricky medical appointment), a more serious issue might occur with
persistent intrusive thoughts. It might help to try and see if there is a way
you can stop thinking or worrying about certain issues.

Step 2: Try not to focus on the content of your intrusive thoughts.

It is often useful to think about a time when you had the same intrusive
thoughts you are having now, but instead of dwelling on them (which tends
to make things worse), try to change your relationship with them. For
example, if you have an intrusive thought that keeps coming back to your
mind, it might be useful to see whether you can find a different way of
dealing with it. Also, do not focus on its content if you dwell on why this
thought came into your mind. Instead, focus on other issues, such as
whether the thought makes you feel more anxious or less anxious or
whether it is helpful to think about the content of your thoughts. It might
also be useful to ask yourself if there is any benefit in repeatedly thinking
about your intrusive thoughts. If there is, then what is that benefit?

In many cases, people with OCD notice that focusing on the content of their
intrusive thoughts or trying to change how they think about them can
worsen things. This is because as soon as an individual tries to stop having
a particular thought, it becomes more difficult for them not to think about it
again. After all, when we try and control our minds, we cannot do so
without effort.

Step 3: Work out if you can find a way of trying to stop having your thoughts

This is similar to Step 1 but focuses more on the process of trying not to
think about something than simply looking for a change in relationship with
your thoughts. For example, if you try not to think about your intrusive
thoughts (or find ways of trying to stop them) without changing the meaning
behind your thoughts, they are likely to come back again. It may be useful
at this point, however, not just to ask yourself whether you can think of
ways of stopping certain thoughts from entering your mind but also whether
there is any benefit in continuing to have certain types of thoughts. If there
is, then what is that benefit? For example, if you believe it will help you to
think about your intrusive thoughts, then ask yourself whether this belief
makes any sense and, if so, why.

Step 4: Try to accept unpleasant thoughts without judging them.

Sometimes when we have intrusive thoughts, we tell ourselves that they are
wrong or upsetting, making them more likely to come back in the future.
However, one of the core principles of ACT is that anxious thoughts do not
necessarily mean anything negative about a person. It may be useful,
therefore, not to accept these thoughts without first questioning whether
they have a purpose in our lives.

A useful way to try and work out the purpose of your thoughts is to see
whether you can find any evidence for them. It may be helpful, for example,
to ask yourself if there is any reason why you have these intrusive thoughts.
Examining this question can prove helpful because we often only consider
ourselves guilty of something when we have guilty feelings, which are often
painful and distressing. If the thoughts do not seem to make sense or lead
us anywhere, then it might help to consider whether you could benefit from
letting go of them altogether. If there is any benefit in continuing to have
these types of thoughts, what is that benefit?

Step 5: Make a plan to get rid of your thoughts.

This step examines whether it would be helpful to take practical steps using
a three-column worksheet to eliminate or reduce the impact of unwelcome
intrusive thoughts. The worksheet has three columns on the left: Yes/No
and Agree/Disagree. The first column is for rating the extent to which a
certain thought is true (from 0% meaning not true at all to 100% meaning
true). The second is rating the extent to which a certain thought is helpful
(from −100% meaning completely unhelpful to +100% meaning completely
helpful). Finally, the third column is for rating the extent to which a certain
thought is unwanted (from 0% meaning not wanted at all to 100% meaning
wanted).

When completing these columns, it may be useful, in some cases, to

consider what you are doing when you think about your intrusive thoughts.
For example, you may ruminate on them or engage in other behaviors that
will cause you distress. If this is the case, it might be useful to ask yourself
whether there is a more helpful way of dealing with these thoughts.

In addition, it may be helpful to focus on your willingness to carry out

certain assignments to reduce the impact of intrusive thoughts. A key
question in this step will be whether you are willing to complete
assignments related to trying not to think about your intrusive thoughts or
thinking about them differently. You can check how willing you might be by
asking yourself whether you would agree or disagree with statements such
as "I'd like to get rid of my unwanted thoughts. I am willing to do this". If
you wish to challenge many of your intrusive thoughts, then it would be a
good idea to download the following worksheet.

Step 6: Confront your thoughts and change the meaning of them

This is not an individualized process because it can be useful for people
with OCD to access external help and support at this stage. However,
several tools may be helpful for people with OCD when they are ready to
confront their thoughts and change the meaning behind them.

The first is an "unwanted thought diary," which helps people to record the
number of unwanted intrusive thoughts they have each day. In addition, the
diary can monitor how a person's vulnerability or risk of experiencing
unwanted intrusive thoughts increases or decreases when they change their
behavior in certain ways.

Second, it can be useful for people with OCD to make action plans to
prepare themselves for situations that are likely to increase their risk of
experiencing intrusive thoughts. Action plans may also help individuals to
carry out other assignments more easily, such as confronting the meaning
behind their intrusive thoughts, eliminating them from their minds, or
looking out for alternative ways of living with these types of thoughts
without letting them get in the way of their lives.

Third, people with OCD need to engage in behavioral experiments because

they may need to determine whether their thoughts are true. For example,
they may wish to challenge the thought, "I will not be able to stop myself
from carrying out this type of behavior." But, of course, it is impossible to
show that one cannot do something, so a more reasonable question would
be, "Am I able to stop myself from doing this behavior?" This question can
then be answered by carrying out different behavioral experiments.

A final point about confronting your thoughts is that it might help

considerably if you have someone else who can provide external support as
you carry out these experiments.

Step 7: Carry out assignments and practice new skills.

Here there are several exercises that you might consider. For example, the
"unwanted thought diary" can monitor how a person's vulnerability or risk
of experiencing unwanted intrusive thoughts increases or decreases when
they change their behavior in certain ways. Often people with OCD find they
can eliminate intrusive thoughts by carrying out behavioral experiments,
particularly if they are performed in combination with other assignments.
Moreover, many people with OCD have found it useful to keep a journal of
their progress using the following worksheet.

Finally, as already mentioned, it is important to change the meaning behind

unwanted thoughts, which can be done in several ways. One way is to
employ thought-stopping. Another way is to participate in slow-wave
therapy (SWT), based on research showing that people with OCD have
hyperactive brains responsible for their intrusive thoughts. SWT tries to
slow down a person's brain activity using visual or auditory stimulation. The
visual stimulus involves having light in the person's eyes while inside an
MRI machine (a safe type of magnetic resonance imaging scanner). The
auditory stimulus involves listening to specific sounds while they are inside
the scanner. SWT has been shown to reduce the impact of intrusive
thoughts and is associated with improvements in cognitive function.

It is also important to carry out the suggested assignments because they

may help you to challenge your thoughts and tell yourself that they are not
true. This can be difficult when you have a genuine experience of anxiety,
but it is important for you not to feel that you are doing a worthless thing,
as this can make intrusive thoughts seem more powerful. In summary, your
assignment might be to think about how much your thought bothers you,
whether you could think about this without being anxious (or at least
without being bothered) and whether there is any better way of coping with
it.

Step 8: Use exposure and response prevention (ERP) to change your

behavior

It is important to note that ERP is ineffective if it is not carried out

consistently and regularly. Therefore, whenever you carry out assignments,
you should try to do so as thoroughly as possible and with a high degree of
commitment. For example, you should make sure that when carrying out
exposure tasks concerning confronting your thoughts, you ensure that you
are in the same environment each time (e.g., at home), so it might be
helpful to try to carry these out at the same time each day.

ERP involves trying to think about your unwanted thoughts without being
anxious. It involves consciously stopping yourself from carrying out the type
of behavior you have been anxious about. These assignments aim not to get
rid of intrusive thoughts but to practice not thinking about them for a short
period. To do this, carry out at least one exposure task and one response
prevention task each day to challenge your intrusive thoughts.

It may be helpful if you find it difficult to change your behavior by yourself,

for example, if you are very anxious about not carrying out your
assignments. You should seek help from a therapist or another person who
can support you in your attempts to manage your intrusive thoughts and
help you with other aspects of OCD.

A therapist or other professional must help with exposure tasks and

response prevention, as you may need regular feedback on how well these
are going. Still, it can also be helpful if the task is done in a supportive way.

How to overcome addiction and substance abuse

Rehab. It's something a lot of people have to go through, but it's not always
easy. When you're coming from an addictive lifestyle, it might seem like
you'll never be able to fully recover from the drugs or alcohol that have
been controlling your life for so long. You might feel hopeless and like rehab
is just a waste of time. But here are some important things to know before
making this decision:

The first step in overcoming addiction is understanding that there is no "just

one drink.”

This is a common tactic used by people in denial – they will rationalize their
way around their addiction and attempt to convince themselves that this
one drink isn’t a big deal. But it is a big deal because no matter how much
you want to be sober, you cannot trust yourself around alcohol. You would
not be reading this book or considering addiction treatment if you weren't
already convinced it was okay to give up alcohol entirely.

You may have been using alcohol daily for a long time, so your decision to
enter treatment is a lot riding on. If you decide not to go through with it,
you will have the rest of your life to regret it.

Take some time to consider if you want to do this. You might be wondering
what's so scary about getting clean and sober – even considering that the
only thing worse than an addict could is an addict who doesn't ever get
clean. The truth is that addiction takes hold of you in ways that can be very
hard to control once it gets a hold of you and keeps you trapped in its grasp
forever. You will be much happier and healthier if you get sober now.

Stay clean and sober if you are deathly afraid of being an addict for the rest
of your life. It's much better to be a recovering alcoholic than it is not to be
an alcoholic at all. If you're not ready yet, don't feel bad about that – after
all, what kind of self-respecting addict would even consider entering rehab
if they weren't at least a little bit concerned about their future? But once
you've decided, do not doubt that doing so is right for you.

If you've already tried rehab, or if you're not sure whether or not you're
ready to get sober, go into recovery by yourself.

This is one of the smartest things that can be done to deal with a problem as
serious as addiction. While it might look like you're going in alone, some
people have gone through similar experiences in the past and are more than
willing to help any newcomer out. That person could be a family member; a
friend; or an acquaintance who has done it before and can tell you how the
process works. It could even be someone at the treatment center getting
ready for their trip through rehab.

You will feel alone at first in this situation. Even if you're going through
detox and feel that it's not as bad as you thought it would be, there are still
many difficult things to get through on your own. That makes every day in
recovery feel like a new beginning to all the old feelings and behaviors you
have been accustomed to. At this point, the best thing to do is to go with the
flow and try not to stress over your recovery too much. The fact is that
getting clean, sober, and staying that way is hard work on its own. But
when people show love and support during this time of transition, they can
help keep you on track in your journey towards long-term sobriety.

Many drug and alcohol rehab centers can help you if you don't know where
to start. They have licensed professionals who can guide you through all of
the steps involved in getting clean. In addition, they have all the facilities
and resources needed to ensure that you don't just go through detox but
also go through detox and treatment in a way that is safe for your physical
health, mental health, and entire lifestyle as a whole.

When entering any drug or alcohol treatment, it's important to remember

that recovery takes time and to understand the expected results of different
programs.

Therefore, these tips can help you overcome addiction and substance abuse:

1. Commit to Developing and Following a Personal Recovery Plan.

A personal recovery plan is a powerful tool that helps people learn what
they need to do to overcome addiction and substance abuse. A personal
recovery plan is a document that lays out all the steps involved in getting
clean and sober. It centers on what must be done, how it must be done, and
when it must be done.

A personal recovery plan is designed for people who are still in the process
of trying to understand addiction and substance abuse. A personal recovery
plan guarantees that people will understand the problem and know what
needs to be done about it.

A personal recovery plan provides a sense of responsibility for oneself,

family, friends, and loved ones who might experience adverse drug or
alcohol abuse effects. A personal recovery plan is an effective tool that can
be used by people of all ages, genders, nationalities, and religious
affiliations. A personal recovery plan is the cornerstone of managing
addiction and substance abuse.

A personal recovery plan ensures people have a sense of ownership over

their lives and well-being.

2. Learn Effective Coping Skills and Life Skills During Addiction Treatment.

Life skills are essential to help people understand how to control their life
instead of letting alcohol or drugs control them. Life skills also help people
manage their everyday stress positively, so they won’t be tempted to resort
to drug or alcohol consumption just because things aren’t going right with
their lives.
Effective coping skills can also help people manage their emotions and
lower the stress in their lives. For example, one successful approach would
be learning a new skill, such as how to fold laundry or make a nutritious
meal for dinner. In addition, people who go through addiction treatment
and recovery can use these coping skills to keep themselves out of trouble
and on the right path.

The more effective coping skills people use, the less likely they will resort to
alcohol or drugs because of stress. Effective coping skills combined with
other techniques, such as learning effective life management techniques,
have been proven to help people quickly overcome addiction issues by
preventing relapse.

3. Do Not Fret About Relapse During Addiction Treatment.

Relapse is a natural part of recovery, and it’s something that all people will
experience during addiction treatment. However, relapse does not mean
failure. Instead, relapse happens because it is a part of the recovery
process. Addiction treatment approaches and techniques can help people
mitigate this challenge through relapse prevention techniques and
therapies.

There are many approaches to help prevent relapses in different stages of

recovery. Therapies that prevent relapse are very effective as they can be
offered to anyone thinking about relapsing or someone who has been
identified as having a higher risk for relapse. In addition, effective therapy
can be done in a short period, providing long-term benefits to the person
undergoing treatment.

4. Find a Mentor in an Effective Addiction Treatment Program.

When people go through addiction treatment, they have to engage in an

interactive experience that involves more than just attending lectures and
watching videos. The experience should involve people learning from other
human being who has been through what they are going through right now
during their recovery process. This person doesn’t have to be a professional
counselor. One of the best mentors is another individual who has
successfully overcome addiction issues and is living a clean and sober
lifestyle today.
Mentors can show people the steps needed in their journey to help them
overcome addiction and substance abuse issues. They can help people
understand what works for them, as well as what doesn’t work for them.

Mentors can be a driving force in helping people succeed in their recovery

endeavors. They can act as mentors, teachers, and role models during the
treatment process. In addition, mentors are often important to keep people
connected during this transition, so they can continue performing on a
positive note after they are released from rehab.

5. Learn About the Recovery Process.

People entering addiction treatment should be prepared for what will be

expected of them during the recovery process. They should be prepared to
follow a good approach to achieve a successful and sustainable recovery.
This can help them successfully learn how to overcome addiction and
substance abuse issues in the long run.

The good news is that there are many effective ways of getting clean and
sober, and people who want to get sober can learn about these ways in
addiction treatment programs. There are many types of programs like
residential treatment, outpatient treatment, intensive outpatient treatment,
day programs, and more. These programs are tailored according to an
individual’s needs and their commitment to recovering from this life-
shattering disease called addiction or substance abuse.

There are also many addiction treatment approaches like 12-step programs,
non-12-step programs, holistic approaches, and more. These different
approaches work in different ways to provide effective addiction treatment.

By learning how these different approaches work toward helping people get
sober and stay sober in the long run, people will be able to make better
choices in their recovery process. In addition, people can make more right
decisions without relying on others during their recovery process.

Addiction Treatment Can Help People Get Clean After Neglecting It For So
Long

There are many reasons why people end up neglecting addiction treatment
and recovery for such a long period. The good news is that no matter why
people neglect addiction treatment, it’s never too late to get some help and
create a new and better life for themselves. The earlier they get treatment,
the easier it will be for people to overcome addiction issues throughout
their life.

Addiction treatment can positively change lives so that people who have
neglected to get help in the past can be more confident in their future.
People struggling with an addiction issue right now should take advantage
of available resources by attending effective drug rehab. It’s never too late
to get sober, so there is no need for addicts to wait when help is readily
available at their doorstep.

Recovery is a process that requires accountability and commitment.

Recovery is not just about what an individual does but how the individual
behaves after participating in the recovery. People who truly want to
recover from substance abuse problems and addiction must ensure they get
the most out of their recovery. The sooner people get treatment, the easier
it will be for them to overcome addiction problems.

Many different types of programs are available today, so there is no reason

not to be willing to get help if you have denied yourself this type of support
system before. The more time passes without attending an addiction
treatment program, and the more difficult recovery will become. Don’t let
your fear of recovery stop you from getting help by attending a good
addiction treatment program.

Many decisions can be made in life, and people often find themselves
paralyzed by the choices in front of them. People who want to recover from
an addiction or substance abuse problem must commit to getting the help
they need. When people get treatment, they can address their addiction
issues head-on effectively, improving their long-term chances of recovery.

People who avoid getting help only make it difficult for themselves and their
loved ones to address addiction problems as they progress further into their
addictions.

How to understand yourself through ACT

Acceptance and Commitment Therapy (or ACT) is a 4 – step psychological
process that can help greatly in improving one's life. The first step of ACT,
as stated by its founder -- Steven Hayes, Ph.D. -- is to "take an accurate
inventory" of oneself. This means objectively assessing how the person
views themselves and their current situation.

In the second step of ACT, one must analyze whether the thoughts and
feelings they have about themselves are based on reality or if they are
instead based on unrealistic expectations that are not being fulfilled. The
person is encouraged to accept if they are not based on reality. The third
step of the ACT discusses how one's feelings and thoughts influence
behavior. The third step helps one understand how they act and how this
compels them to continue to act in certain ways.

In the fourth step, the person is encouraged to commit to change. This

involves making an active choice to stop doing things they are now doing
and start doing something different.

Steps 1-3 can be difficult for some people because it means accepting flaws,
imperfections, or setbacks that have affected their lives in the past. It
means facing emotions from the past. It also means looking clearly at the
present situation because that is where one's behaviors are most likely to be
repeated.

ACT is not a quick fix. Most people who use the methods of ACT for self-
improvement will report that it takes time to accomplish their goals. The
first step alone can take months or years because it involves an honest self-
assessment and some difficult emotions.

Step 2, where one looks at the relationship between thoughts, feelings, and
behavior, also involves facing both old experiences from the past and
painful emotions from those experiences. This can also take time to work
through because most people don't know how to go through this process. It
requires gaining knowledge about one's personal history and understanding
how they learned their behaviors as they grew up.

Every person says they want to improve themselves in some way.

Unfortunately, many try to do this based on advice from other people and
not by using the actual processes available through ACT. As a result, they
may waste time and get frustrated and discouraged. However, people who
have been helped by ACT can report that the methods have made a
profound difference in their lives, leading them to higher levels of self-
esteem, better relationships with others, and greater happiness. Instead of
being constrained by the past, they can say they have learned to live in the
present and plan for a bright future.

These tips can help in understanding yourself through ACT

1. Acceptance:

Acceptance is the first step in the ACT. Accepting is accepting that you are
imperfect, flawed, or incomplete. You can't change what you don't
acknowledge first. For example, frequently resentful or unforgiving people
cannot accept themselves because of their inability to accept others as they
are. Accepting others helps us to accept ourselves, too, because we realize
there is nothing wrong with us and that we need not be so hard on
ourselves.

2. Commitment:

Commitment is the second step of ACT and involves making a genuine

choice in favor of your growth objectives (our goals). We commit to
improving our life by making an active choice to stop doing something that
is not working and start doing something else that will work better for us.
Commitment means putting forth a higher effort and doing what is required
to reach our goals.

3. Values:

A value is something that you think is important and meaningful in your life.
It may be a goal, ideal, belief, quality, or experience you want to increase in
your life. There are two types of values: terminal values and instrumental
values. A terminal value is an ultimate aim or the highest goal you hope to
achieve in your life, while an instrumental value refers to the steps needed
to reach a terminal value. If our behavior conflicts with our values, we
experience cognitive dissonance, which refers to psychological stress
experienced when two attitudes or beliefs are inconsistent.

4. Life Compass:
The life compass is an easy way to remember the steps of the ACT. The
steps are A-Acceptance, C-Commitment, and T-Values. This is a simple way
to remember these terms and the order of the process (A-C-T). Remember
that this process cannot be rushed; it takes time, patience, and growth on
your part, but it can make all the difference in your life.

5. List Activities:

It is important to know what activities you perform daily and then identify
the ones that work and those that don't. You want to identify the activities
that keep you doing what you are doing when you are not working on
improving yourself. Once you have identified these activities, one of the best
ways to change them is by identifying those that lead to a healthy life. If
most of your daily life has been filled with unhealthy habits, it will be much
easier for you to change them.

6. Observe Your Thoughts:

People who have friends or family members who think they are depressed
but aren't are often unaware of their thoughts. However, this may indicate
that they are depressed because they have been close to them for so long.
This can also make it seem like the depression is less intense when it may
be more severe. Listening to your thoughts can help you better identify the
reasons for your depression and what makes you feel good about yourself.

7. Positive Affirmation:

A positive affirmation is a statement that reflects or describes a positive

truth about yourself. This helps you recognize your positive traits,
acknowledge them, and appreciate how they make you feel good about
yourself.

8. Mindfulness:

Mindfulness is the ability to be fully aware of and attentive to what is

happening in the present moment. It means being aware of your thoughts
and feelings without judging or getting caught up in them.

9. Self-forgiveness:
This is when you accept yourself for who you are, forgive yourself for the
mistakes you make, and move forward with your life. Self-forgiveness
means releasing regrets from the past, forgiving others to free yourself
from guilt, and finding a new way to live that is full of love and joy once
again.

10. Mindfulness Meditation:

Mindfulness meditation teaches you how to sit quietly and focus on your
breathing as you pass judgment on any other thoughts that interfere with
your concentration. This allows you to be more aware of your thoughts,
feelings, and emotions without being attached.

Mindfulness meditation is a simple way to learn how to achieve a state of

mind that is more connected to oneself, others, and the world around them.

11. Acceptance and commitment therapy online:

There are many online courses that you can use to learn about acceptance
and commitment therapy. This will greatly increase your understanding of
ACT (Acceptance and Commitment Therapy) which can help you achieve a
better balance in your life through these processes. Moreover, reading self-
help books is also a great way to learn more about ACT.

12. Change:

Change is inevitable, and it is important to embrace it to improve your life.

Change can be hard at first, but once you can accept change, you will find
new ways of reaching your goals and improving yourself as a person. If you
do not want change, you are likely doing something that is not working for
you and will add stress to your life, leading to depression.

13. Self Regulation and Values:

Self-regulation is the ability to control your emotions and thoughts to

achieve your goals. This is a crucial part of ACT because it helps you deal
with any obstacles that prevent you from reaching your valued goals.

14. Relationship:

It has been said that we are never more than 6 degrees away from one
another. In other words, everyone is connected in some way or another.
Therefore, healthy relationships with others can help improve our feelings
about ourselves, our environment, and the world around us. In contrast,
unhealthy relationships can cause stress and anxiety, interfering with our
ability to learn, grow and improve.

15. Explore:

Sometimes it is good to explore new things that can help improve your life
and learn new skills you never thought you would have. Remember that if
you don't try, you will never know what could have happened, and exploring
new things can also help prevent depression because this gives you
something positive to focus on in your life.

16. Act:

Yes, action is one of the steps in ACT, and it is important to take action by
following the step before it (that is, the pre-conditions). You are making
changes and improving yourself by taking action, which means that those
thoughts and feelings will no longer burden your mind.

17. Routine:

Having a routine can help you improve your life by teaching you discipline
and giving you a better sense of structure in your daily life. In addition,
when you follow a routine, you are more likely to accomplish your goals,
feel happier and be more successful. But remember that having a routine
does not mean that your life will be dull; the key lies in finding a balance
between the excitement of your daily life, spontaneity, and adding new
things into your routine.

18. Tell Others:

Telling others is a powerful way to address any problems, issues, or

concerns we may have as individuals. It is important to remember that
while others may not understand you at first, they can be great support
mechanisms and provide the guidance, comfort, and feedback that we need.

19. Problem Solving:

Problem-solving is one of the most important steps in the ACT because this
step helps you deal with your emotions and thoughts by finding a solution to
them instead of letting them control you. This step often works hand-in-
hand with acceptance because it allows us to learn from our experiences,
deal with emotional pain and find meaning in our actions.

20. Find Help:

If you feel that you cannot make progress in your life, if you cannot solve
problems or find meaning in your life, then it is best to seek help from a
professional psychologist or counselor. It can improve your life if you learn
about the things that are affecting it, such as your thoughts and feelings,
and understand what needs to change to achieve balance in your life. ACT
has been proven effective in treating many psychological issues such as
depression and anxiety; learning more about this process will help you heal
yourself more effectively

Application and benefits of ACT in everyday life

ACT is a therapeutic process that helps individuals and groups to accept
who they are, work on unmet goals, and commit to positive change. The
following book explores the possibilities of ACT in everyday life.

ACT is founded on the work of two models. The first, ACT, was developed by
Jim Reinecke and first published in 1985 in his dissertation. The second
model, called "The Interpersonal Theory of Conflict" (ITCC), was developed
and published by David Shapiro and his colleagues Sheila Kitzinger and
Stephen Hayes in 1983. While many therapists use elements from both
approaches, some important differences are worth noting.

ACT promotes a goal-oriented clinical approach to working with clients. A

therapeutic relationship is viewed as embracing at least one client together
throughout an agreed-upon period. The therapist encourages a commitment
to the therapeutic task and informs the client that changes may occur in
how they define themselves and their world. The goal is not to set up a
relationship that can be maintained indefinitely but can be used effectively
in the here-and-now. ACT assumes that therapy is a change process to
increase healthy behaviors and decrease dysfunctional ones rather than a
process of understanding or insight. Ideas about this approach are drawn
from both cognitive-behavioral and other related therapies.
ITCC seeks to understand how individuals relate to others as it relates to
dysfunctional interpersonal behaviors. It is based on the assumption that
there exist "conflictual cycles" in which persons engage in unfair treatment
of others, resulting in a similar cycle of abusive and abusive responses by
other persons toward the individual. The therapist's role involves fostering
an ability to recognize these cycles and become aware of their existence.
Thus, ITCC therapists aim for collaborative relationships with their clients
with the view that such a relationship is the basis for change.

ACT and ITCC offer clinicians different ways of approaching their

therapeutic tasks. While the emphasis is on collaborative relationships, the
underlying belief systems differ. For example, ACT assumes that change
relates to people's beliefs about themselves and the world. On the other
hand, ITCC assumes that change involves learning to recognize and deal
with conflictual behavior patterns rather than trying to effect personality
change.

Therapists use either a behavioral or a cognitive approach in working with

clients. A behavioral approach focuses on behavior as the vehicle for
change; it is based on a belief that better behaviors are likely to occur when
clients are aware of them (e.g., self-monitoring of client) and able to make
and follow up on plans for achieving them. A cognitive approach focuses
instead on the nature of thoughts, feelings, and perceptions concerning
behavior. It emphasizes interpersonal processes in which clients consider
how they think about themselves and others, how they feel about them,
their relationships, their interactions with others, and so on.

The focus in therapy with ACT clients tends to be on what is happening in

"here-and-now" situations as opposed to theory or conceptualization. The
therapist uses the "experiential avoidance" framework to clarify with clients
the unnecessary costs of attempting to control their subjective experiences.
The idea is that therapy involves learning to "pay attention" rather than
hiding from or trying to avoid internal experiences and feelings. The
emphasis is on helping clients commit themselves to a course of action in
which they will see consistent positive results rather than a course of action
that may result in failure or negative consequences.

Therefore, these tips can guide the application of ACT in everyday life:
a. Identify the "here and now" situations in which you are currently trying to
manage your life by avoiding unacceptable feelings/subjective experiences.

b. Identify the "abusive strategies" you've used to manage these situations

and consider how these strategies have affected you in terms of
interpersonal relationships with others, self-esteem, and health.

c. Make a concrete plan to begin using more healthy strategies for

overcoming your negative patterns with the hope that this will bring about
positive change in "here-and-now" situations regardless of what has
happened previously in your life or what might happen on a theoretical level
of planning, etc.

d. Commit yourself to making this plan work by practicing it before

committing.

e. If you are experienced with ACT and ITCC, you may consider using a
behavioral or cognitive approach in everyday life. If you are interested in
learning more about behavioral approaches, please refer to the following
book:

As we go through our everyday lives, we try to manage what happens using

certain strategies. But not everything works well. Some strategies can be
hurtful and harm others as well as ourselves. ACT therapists help
individuals make the necessary changes in their lives by first gaining
awareness of what they are doing now that gets them into trouble with
others while hurting themselves.

Some things to watch out for are:

a. Trying to force other people or situations to do things your way. This can
backfire and make the situation worse.

b. Not being truly present in any one moment of your day. For example,
suppose you are in a meeting or interacting with another person. In that
case, you may step away from that interaction just as it is getting
interesting or exciting, and then when others try to bring you back in, it will
be too late for them to continue what they need to say to you at the time it
needs to be said.
c. Mind reading about the feelings of others is more accurate than their
feelings (i.e., when you say to a friend, "I just know that you are angry with
me because..."). This hurts the other person and can make them feel
misunderstood.

d. Using the words "should" or "must" or attempting to be perfect at

everything all the time. If you use these words, it will only bring about more
unwanted pressure on yourself and others (i.e., saying to your spouse, "You
should know by now that I 'must' be home from work no later than 6:30. It
is 'should' be obvious to you that I need those 15 minutes to decompress
before seeing the kids, etc.").

e. Attempting to control the outcome of events. In some circumstances, the

outcome of an event is not possible to control, but in others, it is. (i.e., "If I
am late for work again, I 'should' feel guilty about that and then should try
harder to make my presence at work more predictable by taking my car in
for an oil change, etc.")

f. Trying to control your feelings or what you feel or not feeling. It is helpful
to know when you have used such a strategy and let it go now (i.e., "The
other day I felt really angry when.").

Moreover, these are the benefits of ACT in everyday life:

a. Increased ability to tolerate or accept thoughts and feelings present at

any moment.

b. More willingness to experience feelings as they are without trying to

change them. This is an important component of being more fully human
and staying connected to others (e.g., "I am not proud of myself for feeling
'this' way, but I can be proud of my willingness to step up and feel 'this'
way.").

c. Breaks old patterns of avoiding and managing negative feelings,

thoughts, and experiences.

d. Increased ability to be yourself in any given situation (except when

controlling the outcome of events is desired).

e. Increased self-acceptance and a general feeling that life is more

predictable and controllable (in general).
f. Decompression from chronic feelings of being overwhelmed by feelings or
emotions, thoughts or actions that are upsetting to you.

g. A feeling of courage to follow through on an action plan you have made

after carefully considering all the aspects of a situation.

h. Increased personal power over your immediate choices in spaces where

there are few options available to you (i.e., when you are in a meeting, and
the main speaker does not allow for input from others, you may say to
yourself, "I can choose to 'stay' at this meeting or choose to 'leave' this
meeting. Either way, I will survive it, and there are things I can learn from
my experience here.")

i. The ability to take risks rather than being opposed to them (i.e., taking
chances, making mistakes, and failing; these do not equal 'badness' or
'evil').

j. Feeling more confident in your abilities to handle situations that may arise
from taking chances and making mistakes.

k. Increased ability to stand up and say "no" if necessary.

l. Increased feelings of self-compassion, love, and respect for self and

others.

m. The ability to step away from any thought or feeling that is upsetting to
you when you are with others (i.e., if someone says something that triggers
an angry response in you, you can say to yourself, "That's just the way they
are talking right now" so that you can step back from your angry response).

n. Greater access to what matters in your life and less time spent on things
that don't matter (i.e., things like getting ready for work in the morning).

o. Increased ability to "let go and be" in all of your experiences (i.e., in any
situation, you can decide to "just let it be what it is" and "not try to shape or
control events").

However, those new to ACT will sometimes initially feel overwhelmed by

their thoughts, feelings, and behavior. This is normal and should not force
you to decide on your life, but just an indication that you need some time to
get comfortable with the new ideas. So do not worry if you feel
disappointed, confused, or lost after hearing the above explanations for why
you are doing what you are doing.

Therefore, it is very important to accept each new idea in the ACT and give
yourself time to see if the idea works for you and fits your life. Some ideas
might be useful soon, while others might take some time to work through
your system.

When you first begin using ACT, it can be helpful to set aside a specific time
every day for 10–15 minutes or so when you can read through the above
explanations in one of the ACT books or listen to one of the tapes multiple
times, until you understand the idea enough that it becomes a part of your
life.

It is also a good idea to practice applying ACT to your life in real-time

whenever possible to see how well it works for you.

Although you can take the above ideas from ACT and apply them to your life
in any way that seems useful to you, you need to remember one thing:

ACT does not aim to change you or your behavior in any way. It aims to help
you accept how things are, make sense of what is happening and then step
up so that you can act in your own life instead of being stuck in old, harmful
patterns. ACT will never ask you to stop caring for yourself or be perfect at
everything. That would be another way to control others, feelings, or events
(which would create more unwanted pressure on yourself).

ACT is about seeing the big picture of your life and figuring out what works
for you, not just in your mind but in the real world. So be sure to only take
the parts of ACT that fit you and your life while leaving all the rest behind.

Therefore, getting a feel for what will work well for you and what won't.
Then, experiment with ACT to see if it helps you live a better life (rather
than just letting new ideas overwhelm you). And no matter how well or
poorly things go at first, do not give up too soon. Be prepared to try again
and see if something eventually sticks with you or not (and then throw away
whatever doesn't work).

How ACT can help you overcome rethinking holiday stress

According to the Anxiety and Depression Association of America, anxiety
disorders affect 40 million adults (18.1%) in the United States aged 18 and
older. If we look at just general anxiety disorder alone, that number jumps
to 8.7% of young adults (ages 18-29) in this country.

It’s easy to feel helpless when combating common anxieties such as the fear
of public speaking or a fear of heights, but acceptance and commitment
therapy is an evidence-based practice that can help you find peace with
these fears by teaching you how to commit yourself fully to your desired
goal despite any discomfort or negative feelings accompanying them on
your path towards success.

The basic premise of acceptance and commitment therapy, or ACT for short,
is that when we hold on to negative feelings about a situation – in other
words, we continue to fear the future and thereby prevent it from
happening – the only way to truly overcome the consequences of our
developing anxieties is by admitting that those fears are a part of us.

To understand how ACT works, first, it’s important that you understand
what causes anxiety disorders. Dr. David Barlow offers this explanation in a
New York Times book:

Anxiety disorders often begin in early childhood and are often linked to
difficult experiences as children or teens. As children, we learn the rules of
our culture and are forced to make decisions and take actions we don’t
want to do. We may feel ashamed or fail at those tasks, and when we’re
scared, we are also caught in a society that demands perfection.

As adults with anxiety disorders, we struggle with these same issues. We

are often encouraged by our families, peers, and other people around us to
be perfect; they want us to succeed in our careers and ambitions. However,
when we experience an anxiety attack because of our fears about failure or
imperfection, it can become very difficult for us because it’s natural for us
to be threatened by failure even if no one is trying to hurt us.

ACT teaches us that our anxiety disorders don’t stem from the present; they
stem from our past; each of us has learned to fear and react nervously
towards certain situations. ACT helps individuals with their anxieties by
teaching them how to identify and accept the feelings of their anxiety as a
part of themselves, rather than trying to suppress them or run away from
them.

It’s important for you to understand that accepting your own anxieties
doesn’t mean that you approve of your anxiety disorders; it simply means
that you are willing to fully experience the emotions that come with them.
This is the first step towards being able to overcome your anxiety, but it’s a
step that’s easier said than done. To illustrate this point, let’s take a look at
some of the common symptoms of anxiety disorders as defined by the
Anxiety and Depression Association of America:

Therefore, ACT can help you overcome rethinking holiday stress through:

a. Recognizing the triggers and triggers of others

This is important since many anxiety disorders are brought on by common

triggers. For example, the fear of public speaking is brought on by social
pressure and the fear of failure. If we’re able to learn more about the
situations that arise during our holidays (for example, large crowds,
uncomfortable social interactions, and holiday pressure), we can better
manage our anxieties.

b. Learning to accept our own feelings

For us to accept our feelings and therefore overcome our anxieties, we must
first acknowledge them as real parts of ourselves. It’s important to
understand that everyone experiences anxiety at some point in their lives;
it’s merely a matter of how much we allow these feelings to control our
lives. ACT will teach you how to identify and fully experience your feelings
without needing to change them.

c. Practicing mindfulness

Mindfulness is a basic principle of ACT that teaches us how to be fully

aware of the present moment – the good, the bad, and the ugly. It helps us
take an analytical look at our emotions and understand that sometimes our
anxiety disorders can rise out of fear, but they can also lead to positive
outcomes if we are willing to embrace them.

For example, let’s say that you’re afraid of talking in front of a large group
because you’re worried about making mistakes or being humiliated in front
of others. If you practice mindfulness, you will become more aware of the
anxiety and the need for action that’s incorporated with it. Mindfulness
teaches us to:

1. Notice when we feel or think about our anxieties – for example when
we’re waiting in line at a crowded store

2. Accept and fully experience our feelings – for example, let’s say that you
have a fear of public speaking because your shyness makes it hard to speak
up at work or in social situations

3. Remain present in these moments – even if they seem like embarrassing

moments, you must remain mindful and do your best to keep cool and be
attentive

4. Act with deliberate awareness – in other words, you must make a

conscious effort to work with those feelings of anxiety instead of attempting
to run away from them.

d. Remind ourselves that we’re not alone

Even if you’re the only person in your family who struggles with anxiety, it
doesn’t mean you must suffer silently. By being aware and accepting of your
own feelings, you can lean on the support of others around you and ask for
help when attending big holiday gatherings or traveling.

e. Finding personal rituals

It’s important for us to have our own personal rituals that remind us that we
are in control, not our anxieties. For example, if you’re afraid of flying, you
might want to write a list of things that make you happy and remind you of
your loved ones. If your anxiety makes it hard for you to be alone, then try
creating a playlist with songs that calm you down. And if you have the
holiday blues, it may be helpful to listen to music that reminds us of the joys
of the season.

f. Understanding the uncomfortable feelings

This is one of the most important parts of ACT since we must learn how to
accept our feelings instead of bodily or emotionally pushing them away. The
more we resist uncomfortable feelings or try to run away from them, the
more they control us. If you feel that the holidays are a time in which you
struggle the most with your anxiety, then it’s recommended that you try to
accept these feelings and find ways to be mindful of them.

ACT is an active treatment that teaches us how to be aware of our own

feelings and thoughts instead of ignoring them or trying to run away from
them. By implementing the five steps discussed above, we can overcome our
anxiety over the holidays and eliminate many negative emotions and
situations that arise during this stressful time of year.

g. Being willing to accept your own feelings

This is the most important part since it teaches us to take a step back from
our emotions instead of trying to escape them. The more we try to avoid
unpleasant situations or feelings, the more out of control we feel and the
more anxious we become. It’s important for you to understand that
accepting your feelings doesn’t mean that you approve of them. You must
be willing to put yourself into uncomfortable situations for you to overcome
your anxiety disorders.

ACT has helped many people with anxiety disorders, whether it’s a fear of
public speaking, performance anxiety, or even the holiday blues. There are
a variety of techniques that can be used to help you overcome your fears,
but one of the best ways to get started is by attending an anxiety treatment
group where other people with similar disorders can offer their support and
advice.

Since an increasing number of people suffer from anxiety and depression

during the holidays, it’s important for all of us to take action to help those
who struggle with these difficulties. We can do this through practices such
as mindfulness meditation and cognitive behavioral therapy (CBT), which
have been proven effective in treating anxiety disorders.

h. Don’t fight your emotions

Our anxiety is often caused by our attempts to fight or avoid negative

feelings and emotions. Instead, try practicing acceptance of these feelings
and attempt to make sense of them. This means that you must stop trying to
push away your worries and accept them as a natural part of life. By making
space for uncomfortable emotions, you free yourself to live more fully in the
present moment.

ACT teaches us that some of our most challenging emotions can be faced
directly with mindfulness practices and acceptance exercises. These steps
help us become more aware of our own thoughts, feelings, and sensations –
even the painful ones – so we can reframe them and make sense of them
instead of running from them or trying to change them.

i. Finding meaning in our emotions

This means we must find a way to make sense of our feelings and thoughts.
This never happens overnight, but by identifying what causes our anxiety
and finding ways to explore and understand them, we can begin to unravel
the thoughts that lead us down a path of confusion and depression.

To help ourselves with anxiety disorders, we must accept that these feelings
are part of life. By learning how to work with them instead of fighting or
avoiding them, we can begin building awareness and acceptance in our
lives. By practicing acceptance, we become more mindful of the present
moment instead of worrying about the past or future and how our anxiety
will affect us.

j. Acceptance is a process

If you struggle with anxiety, then you must understand that it’s a disorder
that will take time to overcome. You cannot fix these feelings with a magic
pill or short-term solution. Instead, you must accept these feelings as part of
your everyday life and work towards living a more fulfilling life. It’s
important for all of us to learn how to live with our problems instead of
hoping that they will magically disappear. And once accepted, it’s important
to find a way to bring the anxiety into our daily life and learn to accept that
these feelings will always be part of us.

ACT teaches us that we must accept our feelings, thoughts, and emotions as
they come and that they are not necessarily bad or wrong. Our emotions are
often a sign of things we need to work on or problems we need to solve to
live fuller lives, which is why we should make a habit of accepting them.

k. Our feelings are a part of us

ACT teaches us that our feelings are not necessarily good or bad, but they
show us things we need to work on. By learning how to control our thoughts
instead of our emotions, we learn how to move on with our lives and
overcome issues that previously held us back. Since anxiety is a disorder in
which negative thoughts cause anxiety and depression, it’s important for us
to understand the difference between feeling anxious and thinking the
thought “I feel anxious”.

Mindfulness with ACT

Mindfulness with ACT has helped me more than any other therapy I've
tried. It has given me a greater sense of self-awareness, and my mind has
also been infinitely calmer and happier. It's the most amazing thing that's
happened to me so far in my life, and I would encourage anyone to try it out
if they're interested in changing their lives for the better.

It's made such an impact on how I view myself and what I can do that I've
taken part in a recent study conducted by MIND UK/NHS on its
effectiveness: 'The Effect of Mindfulness-Based Therapy with Acceptance
and Commitment Technique Compared to Behavioural Activation Treatment
for Depression, which is published online today.

It's a groundbreaking study, one of the first of its kind to compare

mindfulness to CBT for depression. It has raised many questions among
awareness groups that I'd like to address here. Mindfulness with ACT
(MwACT) is used for many conditions, including depression, anxiety, and
addiction. Clients who have benefited from this approach report a reduction
in their symptoms: an increased ability to feel better; fewer negative
thoughts; and an overall sense that they have more control over their lives.
As someone struggling with depression for some time, I'd like to share my
personal experience with you and explain how it changed my life.

The arguments for the effectiveness of MwACT are simple. First, ACT is a
therapeutic approach designed to help people understand how they think
and feel and how those feelings affect their lives. It does this by training
people to become more aware of their thoughts (cognitive) and feelings
(affective) – not necessarily to change them, but so that we can be more
effective at choosing our actions and how to best deal with them. This is an
important skill that is often lacking in the lives of many people suffering
from anxiety and stress, especially those who have ongoing problems with
depression.

The use of mindfulness in treating depression is not new. Still, the excellent
research on this topic led by Professor Mark Williams and colleagues at
Cardiff University has made it clear that mindfulness can help people
suffering from this condition. This explains why MwACT – i.e., mindfulness
with ACT – has become popular among therapists who treat mental health
conditions and sufferers.

Mindfulness is used within ACT to help us become more aware of the

thoughts that typically upset us and lead us down into a battle with
ourselves regularly, or 'fear-rages' as I call them (see here for more
information). ACT helps us to become more able to observe these thoughts
and their effects on our emotions and stop avoiding them by arguing with
them or trying to 'fix' them. The resulting quietness is subsequently
followed by a sense of greater freedom, perspective, and connection with
ourselves, which leads to improved well-being.

With all this in mind, I want to give you my experience using mindfulness
with ACT. I've been working with a therapist called Mark Jenkinson since
May 2013 – and started doing the mindfulness element within my therapy
shortly after that – so I'd like to share some of what I've learned over the
last four months.

ACT therapists work with their clients directly. First, they ask you to set
goals and targets for yourself, then work with you to identify the thoughts
(cognitive) and feelings (affective) relevant to your situation. Once these are
identified, they work together with you to encourage relaxation through
breathing exercises to calm your mind and allow these thoughts and
feelings to surface.

This means identifying the thoughts and feelings that are causing me
distress (there are several ways to do this, including writing some down in a
journal) and encouraging the body to relax to allow them to surface. Once
I've settled down, I ask myself questions to identify what is happening (i.e.,
what am I thinking/feeling?). This usually involves asking myself if this
thought or feeling is true or not – for instance, am I angry at someone? If
the answer is yes, I would like it to be less likely that this will happen again
– so instead of getting angry all the time, perhaps act milder next time. If
the answer is no, I would like to eliminate it (i.e., not be angry at someone
or anything).

Mindfulness with ACT can only really be understood by trying it out for
yourself, and you can do this in many ways: try engaging in a simple
mindfulness exercise, such as the one described here. Alternatively, you
could do some research into the work of Jon Kabat-Zinn and his program
Mindfulness-based Stress Reduction (MBSR), one of the best-known
approaches to mindfulness today.

The results for MwACT are very positive. Essentially, it's about helping you
to become more aware of your thoughts and feelings and allowing you to
observe those thoughts in action. ACT helps you to do this by training you to
become more aware of the present moment – that is, the reality around you
– while simultaneously not trying too hard to change anything.

I believe that this approach is helpful for many different conditions, not just
depression. I would point out that the research on the use of mindfulness
with ACT is comparatively low, but this is changing with more and more
studies being done every year. What's clear so far, however, is that it offers
a very positive approach to dealing with the thoughts and feelings causing
distress.

Mindfulness with ACT can help people overcome difficult thoughts by

helping them become more aware of their everyday experiences and where
they're thinking from within their own experiences. It helps them become
more aware of their thoughts – although perhaps less so than traditional
CBT – to let them go (i.e., let them exist rather than judge them). In this
way, mindfulness with ACT leads to a state of awareness that helps to
remove distress and improve well-being.

This leads to a much greater sense of calmness and control over your life,
which I'm grateful for as it helps with my current depression. This is
something that everyone can benefit from through mindfulness with ACT,
including people who struggle with anxiety or stress.
Benefits of mindfulness with ACT include:

a. Greater self-control: as well as helping to remove the thoughts and

feelings causing distress, ACT helps to identify your thoughts and feelings
to understand them. It then helps you develop greater control over those
thoughts rather than feeling powerless against them.

b. Self-knowledge: through mindfulness with ACT, you can gain greater

awareness of yourself, including your values and what's important to you.

c. Greater self-acceptance: mindfulness with ACT helps you to accept

yourself by allowing you more time to be by yourself without feeling judged
or needing to change anything in particular.

d. Greater motivation: mindfulness with ACT helps you remain motivated to

do things important to you (e.g., making art or music, etc.) and allows you
to focus more on your values.

e. Greater connectedness: mindfulness with ACT leads to greater

connectedness with yourself, others, and the world around you. This is
because it helps you become more aware of your thoughts and feelings,
rather than struggling against them or avoiding them by turning away
(which often leads back into a battle).

f. Greater freedom: mindfulness with ACT helps you become freer from the
thoughts and feelings causing distress. Again, this can be in terms of being
less compelled to act in ways that lead to unhappiness or suffering (e.g.,
needing to control others – e.g., by finding a new partner, changing jobs,
etc.).

g. Greater happiness: mindfulness with ACT leads to greater happiness

because it helps you to become more aware of yourself and what's
happening within your life, which helps you to be more at peace and
content.

h. Greater satisfaction: mindfulness with ACT allows you to experience your

thoughts and feelings as they are, without needing to change or avoid them.
This leads to greater satisfaction (we can only be this way within ourselves).

i. Greater courage: mindfulness with ACT provides the space and trust
required for you to do things that aren't normal or right but are important
for you (e.g., get a new job, leave a current job, change course at university,
etc.).

j. Greater optimism: mindfulness with ACT helps you to be more optimistic

by helping you learn how to cope better when faced with stressful events
and difficult situations.

k. Greater empathy: mindfulness with ACT helps you to develop a more

compassionate attitude towards yourself and others (e.g., if you're sad, you
don't feel the need to blame yourself or others for this).

l. Greater compassion: mindfulness with ACT helps you to develop a more

compassionate attitude towards yourself and others. It helps you to stop
judging yourself and others and allows you to become more humane.

m. Greater awareness: mindfulness with ACT helps you to become more

aware of what's happening within your life, not just your ideas about things
or the meaning that they have for you (e.g., failing to achieve something
important, losing someone important in life).

n. Greater openness: mindfulness with ACT allows you greater openness

towards life by helping reduce internal barriers that might be stopping you
from being or feeling open (e.g., holding onto beliefs about how things
should be, but it's different from reality).

o. Greater trust: mindfulness with ACT helps you gain greater confidence in
yourself, including your self-efficacy (e.g., how capable you manage difficult
thoughts and feelings).

p. Greater willpower: mindfulness with ACT helps you to have better

willpower (e.g., to resist unhealthy food or habits, etc.).

q. Greater creativity: mindfulness with ACT leads to greater creativity in

various ways, including music, painting, writing, and many more. This
includes a greater sense of freedom and choice (e.g., being able to decide
that it's okay not to do something).

r. Greater success: mindfulness with ACT leads to greater success in

various areas, including personal and professional (e.g., moving forward at
work to create something that you're passionate about or finding new
friends who are supportive of your efforts).
s. Greater happiness and well-being: mindfulness with ACT helps you live a
fuller life by lessening the stress and unhappiness you experience.

t. Greater contentment: mindfulness with ACT helps you to gain greater

contentment by reducing the negative thoughts and feelings (e.g., self-
criticism) that get in the way of feeling happy and satisfied with life.

u. Psychological flexibility (including flexibility of your mind), which leads to

greater happiness and well-being: as mentioned above, psychological
flexibility leads to a greater sense of happiness and well-being because it
helps you to see things for what they are, rather than through them being
colored by your thoughts or feelings about them. This includes accepting
your thoughts and feelings, even those that might be causing you distress or
making life difficult for you in some way (e.g., anxiety).

v. Psychological resilience (including resilience of emotions): this refers to

higher levels of emotional and physical resilience, including more resilience
of your emotions and other aspects of your life. This means that you are less
easily stressed out about life's difficulties and less likely to suffer from
depression and other mental health problems caused by stress.

How to introduce patients to mindfulness.

Acceptance and Commitment Therapy is trauma-informed, client-centered
psychotherapy that was first introduced in the late 1990s. It can be applied
to any issue — including to patients who suffer from PTSD or addiction.

It’s based on the idea that we all have three important aspects of ourselves:
our thoughts, our feelings, and our behaviors. ACoT aims to help patients
become more aware of their thoughts, their emotions, and how they act to
live more fulfilling lives by either changing or accepting their behaviors.

Acceptance is important to this foundation because it helps patients learn to

accept their thoughts, feelings, and behaviors. A big reason we act in
negative ways is because of the shame we give ourselves for being unable
to change. To change mental health behaviors, we have to be able to accept
what is happening.
Acceptance doesn’t mean that problems go away; it just means that you
don’t fight them because you decide it’s better to accept your situation and
move forward differently.

Acceptance is a complicated and important concept that can be difficult to

learn. However, with mindfulness training and therapy, you can start to
develop acceptance toward yourself. Mindfulness involves maintaining a
nonjudgmental awareness, or curiosity, of your thoughts, feelings, and body
sensations.

To do this, you’re challenged throughout your therapy sessions to observe

these thoughts and feelings as if you were watching a movie rather than
living it yourself.

This process helps you understand the root of your negative behaviors and
thoughts to stop judging yourself for who you are or what has happened in
the past. It also provides insight into changing your unhealthy behaviors
into something more productive.

Mindfulness practices can help you accept your feelings, which is a vital
step in therapy and recovery. Through mindfulness, you can understand
what your feelings are telling you and how to respond more appropriately.

This practice is also important because it helps you understand the

connection between thoughts and feelings. For example, when we get into
certain situations that make us feel a certain way, we often think about our
past experiences or worry about things going wrong in the future.

Mindfulness helps remove these thought processes from the equation so

that we can focus on the present moment — which helps us understand
what’s causing our emotions to surface in the first place.

Finally, mindfulness can help you establish acceptance toward others by

reminding you that there’s a good chance that they’re experiencing similar
challenges. This outlook helps you focus on the present — your relationship
with them, what’s happening right now — as opposed to dwelling on how
they may have hurt or wronged you in the past.

Another important practice is monitoring what you say to yourself and

others. This practice is done through self-talk. Self-talk is a type of dialogue
that takes place inside your head, and it usually involves words and phrases
like “I should,” “I must,” or “I have to.”

We don’t usually realize we’re repeating these things to ourselves so that

we can become more aware of how our negative thoughts affect how we act.
As a result, we can begin to reframe these kinds of statements and change
how they affect us.

Examples of self-talk include: “I shouldn’t be here, I should have brought a

book to read,” or “I can’t stand this pain. I need a drink and a cigarette.”
During sessions, you can practice mindfulness exercises like observing your
thoughts as if watching a movie rather than living it as you talk about your
past experiences or worry about what may happen in the future.

The following tips can help you learn how to introduce patients to
mindfulness:

a. Find a comfortable space

Mindfulness is all about being present in the moment. So, finding a space
where you can comfortably sit and focus on your breath without distraction
is important. It’s best to find a space that doesn’t have any distractions like
television or cell phones.

b. Start with one minute at a time

When introducing your patients to mindfulness practices, start with one

minute of concentrated breathing.

Start by focusing on your breath and counting each time you exhale for 30
seconds. After 30 seconds, take 1-2 deep breaths and then return to
concentration.

Once this becomes easier, increase the time you spend on concentration
from 30 seconds to 60 seconds. Once you feel comfortable with this,
increase the time to one minute, the recommended length of a mindfulness
exercise.

c. Start with your breath and then move on to your body

So many of us are so distracted by our thoughts that we lose touch with our
bodies. Start by focusing on your breathing and then slowly move to include
other body parts that you may normally shut out, like the pain in your back
or feet.

d. Practice what you’ve learned regularly

The more you practice mindfulness, the easier it will be to apply it to daily
life. Practicing mindfulness is the same as any other skill; it takes time and
practice to become comfortable with the new way of thinking.

e. Start by merely observing your thoughts

You can learn more about yourself and others by observing your thoughts
and feelings without judgment. Try not to judge or react strongly when
negative thoughts enter your mind during this exploration. Instead, focus on
being present in the moment as if you were watching a movie — which
means no reacting or saying anything because that would be like being in
the movie too!

f. Let this be the beginning of a new behavior

Mindfulness has many benefits, including the ability to focus on your

breathing while having a conversation with another person. But mindfulness
can also help you make more positive choices in your life that can benefit
you and others.

g. Keep it simple

Simplicity is important to understanding mindfulness, so try focusing on one

part of self-talk or movement at a time. Also, when using guided imagery,
this should happen very quickly so that it’s easy for patients to follow along
without being distracted by too much detail.

h. Don’t force the process

Not everyone is interested in mindfulness or what it can do for them. Take

things slow and make sure that your patients are receptive to mindfulness
before trying to make it a more regular activity in your sessions together.

i. Have your patient practice with a partner or therapist

Partners, friends, and family members can also be good candidates for
practicing mindfulness exercises with patients. Practicing mindfulness with
another person provides an added benefit because it creates a bond
between people. Also, it’s easier for patients to practice with someone who
may have similar problems and can relate to their struggles rather than
someone who will judge them for having similar feelings or thoughts.

j. Don’t forget to ask your patient about the benefits they have noticed

Whether your patient is having trouble sleeping, staying focused on a task,

or thinking positively, ask your patient if they notice a benefit from
practicing mindfulness. If so, encourage patients to continue practicing on
their outside of sessions.

k. Be prepared for setbacks

Patients often have strong beliefs about what will help them in life — be it
alcohol or drugs, working long hours, and not taking time for themselves or
even relationships with other people. These beliefs may surface before the
benefits of mindfulness can be realized, and they can create temptations
that make it difficult to stay on track with mindfulness practice.

Once patients feel like mindfulness is a beneficial lifestyle change,

encouraging them to practice mindfulness on their own at home can help
them maintain the benefits.

l. Keep yourself grounded

It’s important to note that self-doubt can be just as much of a problem as an

addiction for patients.

As an addiction treatment center counselor, it can be easy to get caught up

in the success of your patients. But you mustn’t lose yourself in their
experiences and remain grounded in what your own experiences have
taught you about mindfulness and recovery from addiction.

m. Don’t overdo it and burn out

Sometimes less is more when introducing people to mindfulness because

they will automatically incorporate mindfulness into their lives without
trying too hard once they understand the concept.

But it’s important to remember that mindfulness is not an on-off activity —

it’s a way of being present in the moment and living.
n. Make mindfulness available at your addiction treatment center

Being available to patients interested in learning more about mindfulness

will help you get through practicing mindfulness at home more quickly.

o. Be willing to make changes as you learn more about your patients and
their needs

It can be hard for counselors and addiction specialists to change their

practices as they discover new ways to help people move forward in
recovery from addiction or other mental health conditions. However, being
open to new techniques will allow you to better serve your patients and see
the best results.

p. Use mindfulness in other ways at your treatment center

Like how you incorporate mindfulness into individual treatment sessions,

you can include mindfulness in group counseling and other activities at your
addiction treatment center. Mindfulness can benefit active addiction care
programs, relapse prevention programs, and inpatient sub-acute mental
health addiction treatment programs.

q. Observe how people respond to different exercises or practices

Like anything else, some patients will respond better to one type of exercise
than another. This varies from person to person, so experiment with
different exercises or practices to find out what works best for your
patients.

r. Ask your patient to create their mindfulness exercise

Patients need to do their mindfulness exercises at home because this

provides a sense of ownership over the practice. This allows them to set
goals for themselves and take ownership of the results they are getting from
practicing mindfulness on their own.

s. Provide ideas or resources that will help your patient learn more about
mindfulness

You can help your patients find resources related to what they have learned
in therapy if they are interested in learning more about different types of
exercise that may be helpful with their recovery process.
t. Refer your patient to other resources if they are interested

There are several techniques, practices, and ideas that you can use when
introducing mindfulness exercises to patients. If they are interested in
learning more about other techniques, take the time to learn more about
mindfulness and share what you have learned.

u. Encourage your patient to share their successes with others

If your patient is practicing mindfulness exercises at home, ask them how

they feel about the results and if they want to continue following through
with the practices after treatment.

Mindfulness is a therapy to treat depression, anxiety, stress, and sleep

disorders. Mindfulness-based therapies such as mindfulness meditation are
regularly used to treat pathological levels of thought patterns and negative
emotional states in treating children with ADHD. When used with children,
mindfulness-based therapies have been shown to reduce hyperactivity and
academic challenges, improve concentration and reduce depression and
social anxiety symptoms in children. It has also been shown to help treat
physical ailments such as pain and blood pressure.

Stress management through mindfulness

Stress management through mindfulness is becoming increasingly popular.
As a result, more and more people are trying to find ways to reduce their
levels of anxiety by enrolling in acceptance and commitment therapy (ACT).
ACT is a cognitive-behavioral therapy designed for people suffering from
psychological issues such as depression or anxiety. It is based on the idea
that our lives have three systems: automatic thoughts, values, and action
tendencies. Automatic thoughts can be beliefs about ourselves or others
that seem true but do not match reality; values are things we care about;
action tendencies are the patterns of behavior we have associated with our
goals at any given time. A therapist will help an individual address stressful
thoughts with evidence-based strategies. The client will then develop a
written acceptance plan, or effortful commitment plan (ECP), that looks at
values, action tendencies, and automatic thoughts associated with their
goals in life. An ECP will help the individual identify how they can reduce
their anxiety and negative affect levels by taking specific actions towards
their goals in life. An ECP is often used because it is quick and easy to fill
out and a very effective method of managing stress. Individuals can refer to
their ECP whenever they need a reminder of what they should do to meet
their goals.

Despite the positive results that ACT has shown, many therapists report
that adherence is still a problem in their practice. This is because people
often struggle with understanding the concepts of mindfulness, automatic
thoughts, and values. It can be difficult for an individual to understand the
connection between mindsets and automatic thoughts. Understanding the
difference between mindfulness and values can also be confusing and
overwhelming.

The key reason adherence has been so difficult for many therapists is that
there are many different ways to achieve mindfulness. For example, in ACT,
many different mindfulness strategies can be used. They include mindful
awareness, compassionate acceptance, and non-judgmental observation.
Each strategy has a unique purpose and is designed for a different goal. For
example, attentive awareness is often used to curb negative thoughts and
damaging beliefs about oneself or others.

In contrast, non-judgmental observation can be used to develop more

positive feelings about oneself and others by practicing thought sampling.
The idea behind sympathetic resonance is that clients will start feeling
better because they will recognize when they hear their inner voice
(automatic thoughts) instead of engaging in repetitive cycles of negativity
towards themselves and others. Thus, this is a very specific and targeted
technique that focuses on the individual's goals in life.

For therapists, it can be difficult to understand how mindfulness can help

individuals manage stressful thoughts. This is because it is a very complex
concept that concerns the mind and body. As a result, ACT therapists often
ask their clients to practice mindfulness meditation. This meditation
technique involves concentrating on a single point of focus for as long as
possible, which can look like following one's breath or focusing on one's
body weight in a certain way. However, although therapists sometimes
recommend mindfulness meditation, it has often been shown to have little
effect on a person's situation. This is because the different forms of
mindfulness are not all intended for the same purpose. Therefore, it can be
difficult for an individual to practice one form of mindfulness alone without
practicing the other forms that ACT suggests. In addition, those who
practice meditation for a long period may suffer from various health
problems such as back pain or insomnia.

Mindfulness is effective in reducing stress and anxiety in both adults and

children above the age of 8 years old. However, research shows that this
can only be achieved when there is a safe environment where people can
practice mindfulness. Mindfulness is not only about the practice of
attending to full awareness of one's experiences and inner thoughts, but it
also involves the reduction of harmful thoughts and stressful experiences.
Because it can be very difficult for people to learn how to deal with their
stress and anxiety on their own, many therapists will recommend that their
clients attend group therapy to practice mindfulness and learn new skills.
For example, a therapist may ask one of their clients to go over goals with a
partner they both know to stimulate conversations about what they are
doing in life and how they plan to achieve them.

Therefore, these tips can guide stress management through mindfulness:

a. Practice mindfulness meditation daily by focusing on one single point of

focus, such as following one's breath or focusing on one's body weight while
standing up. If a person is already practicing mindfulness, they should
practice paying attention to the moment rather than concentrating on a
particular thought or feeling. For example, if a person feels anxious, they
should instead notice their breath coming in and going out rather than
thinking about how anxious their feelings are. This will help them reduce
their anxiety levels and improve their states of mind.

b. Practice mindful awareness daily by using compassionate acceptance as a

different way to perform mindful awareness. For example, in compassionate
acceptance, a person should not try to control their thoughts but rather try
to notice thoughts connected to their goals.

c. Practice sympathetic resonance every day by trying to listen without

judging the inner voice of oneself or others. This means that you will start to
recognize when your automatic thoughts are repeating themselves and can
change how you respond to them. You will also be able to acknowledge and
value your feelings, even though these feelings may sometimes differ from
those of others around you who share similar goals in life.

d . Practice mindful awareness by identifying and then working through any

harmful automatic thoughts that may be causing problems for an
individual's goals in life. For example, suppose a person notices that they
have fallen back into their old ways of thinking and responding to stressful
experiences. In that case, they should try to identify these harmful thoughts
as quickly as possible to return to their goals. For example, if an individual
feels sad or angry toward their partner, they should try to pay attention to
the situation to identify what is causing this emotion.

e. Practice mindful awareness by maintaining proper posture when standing

and sitting. For example, an individual should sit with good posture and
ensure they are not slouching while exercising or feeling stressed. This will
help them feel better physically while helping with their anxiety and stress
levels in the long run.

f . Practice sympathetic resonance by listening to the internal voice of

oneself or others without judging it. This way, you can avoid getting into a
negative cycle of repetitive harmful thoughts and feel better about yourself
and your life goals.

g. Practice mindful awareness by focusing on personal values rather than

getting caught up in harmful thoughts about an individual's close
relationships. For example, people should concentrate on their relationships
rather than comparing themselves to those around them who may be more
successful or have achieved more overall goals in life thus far.

h . Practice mindful awareness by using positive self-talk instead of talking

negatively to oneself or others throughout a stressful experience. Research
shows that this can increase a person's self-esteem, decrease their anxiety
and stress levels and improve their overall outlook on life.

i. Practice sympathetic resonance by listening to the internal voice of

oneself or others without judging it. This way, you can avoid getting into a
negative cycle of repetitive harmful thoughts and feel better about yourself
and your life goals.
j . Practice mindful awareness by focusing on personal values rather than
getting caught up in harmful thoughts about an individual's close
relationships. For example, people should concentrate on their relationships
rather than comparing themselves to those around them who may be more
successful or have achieved more overall goals in life thus far.

k . Practice mindful awareness by using positive self-talk instead of talking

negatively to oneself or others throughout a stressful experience. Research
shows that this can increase a person's self-esteem, decrease their anxiety
and stress levels and improve their overall outlook on life.

l . Practice compassionate acceptance by understanding that children may

not be able to follow in their parent's footsteps. Instead, parents should try
to nurture their children's talents and strengths and help them to overcome
some of their weaknesses. This will encourage children to feel better about
themselves more consistently and more confident in pursuing goals in life.

Mindfulness can be applied as a therapeutic intervention in any field of

medicine but is particularly beneficial and highly recommended as a coping
mechanism for chronic illness management. As a result, the medical
community has suggested that mindfulness training should be incorporated
into many treatment plans for various health problems. Mindfulness can be
beneficial for improving coping with chronic pain, stress, anxiety, and
depression. For example, in one study, patients who practiced mindfulness
meditation for eight weeks reported significantly less pain and
psychological distress than patients who did not practice. Similarly, patients
participating in a 12-week mindfulness program could also decrease their
stress levels, depression, and negative outlook on life. In addition to these
improvements in psychological health, many participants also experienced
an improvement in their chronic health problems (for example, a reduction
in pain), indicating that mindfulness may be especially beneficial to people
with chronic illness management.

Mindfulness has been defined differently, but a few common components

are found in these definitions. One definition is "a moment-to-moment
awareness of thoughts, feelings, and bodily sensations." This means that
mindfulness is not only about the practice of attending to full awareness of
one's experiences and inner thoughts, but it also involves the reduction of
harmful thoughts and stressful experiences. Mindfulness also involves being
aware of and accepting emotions like pain while decreasing suffering, which
is beneficial in managing chronic pain. Another definition of mindfulness is
"the awareness that emerges through paying attention on purpose, in the
present moment, and nonjudgmentally to the unfolding of experience
moment-by-moment." This definition stresses the importance for
practitioners to observe when a client's mind wanders onto a negative
thought that may perpetuate thoughts in an ongoing cycle that causes
harm. Mindfulness can be applied as a therapeutic intervention in any field
of medicine but is particularly beneficial and highly recommended as a
coping mechanism for chronic illness management.

The next chapter will discuss Highly Sensitive Empath. This is when people
are highly sensitive to pain, emotions, and their surroundings. Their
nervous system is hyperactive and can be overwhelmed by many stimuli. As
a result, they often have high anxiety and depression but can also be high
functioning on many levels because of the challenges they face in the world.

This brings us to the second kind of Sensitivity. Highly sensitive people are
very aware and reactive to all things happening around them, especially
related to pain and emotions. These individuals' nervous system is
hyperactive and can be overwhelmed by too many blissful stimuli like
music, smells, sensations, tastes, etc. They often have high anxiety and
depression but can also be high functioning on many levels because of the
challenges they face in the world. They are more often introverted than
other groups of people. Highly sensitive people have greater empathic
abilities and are more intuitive. Unfortunately, highly sensitive people can
suffer from underemployment; they lack the resources to manage their
higher awareness and sensitivity (possibly because they do not know how).
Chapter 4. HIGHLY SENSITIVE EMPATH
 Characteristics of a highly sensitive person
Highly Sensitive Empaths are people who automatically feel others'
emotions and the world around them, just as other people feel the good or
bad colors in their immediate surroundings. They might constantly be
moved by different sights, like a church mural, which is why they may
appear distracted or in tears at times. Highly Sensitive Empaths get thrown
off by bright lights, loud noises, rough fabrics, or people crowding into
small spaces. When empaths reach their limit, they can become introverted
and reclusive. They are so deeply in touch with their feelings that the
slightest thing can lift them to the heights of happiness or plunge them
down into the depths of depression.

Empaths are often unusually sensitive to electricity and electromagnetic

fields from light bulbs, stereos, and computers. As a result, they may
psychically pick up thoughts or "feel" when someone is approaching long
before others sense it.

Highly Sensitive Empaths are also often very creative people who may
express themselves through art, writing, music, and dance. They also have
above-average empathy for other people's problems and can be of great
help.

Empaths are the healers and peacemakers of the world. They may do well in
a helping profession, such as medicine or counseling.

Highly sensitive empaths have an uncommonly strong ability to sense

others' moods, feelings, and thoughts. They are exquisitely aware of the
world around them, including sounds that others don't notice, scents that
others don't distinguish, and textures that others can't feel or touch. They
notice the emotions and feelings of everyone around them. They may be so
sensitive to others' moods, feelings, and thoughts that they can even feel
when other people are anticipating their next words or movements.

Empaths typically have a strong ability to feel other people's emotions from
an early age. They pick up on the subtle nuances of what others are
thinking and feeling, even when those nuances are not being said aloud.
Empaths may have an almost supersensitive sense of touch: their skin is
more sensitive than average, which some empaths use to their advantage by
unconsciously interpreting others' gestures and movements as simple touch
sensations.

As they grow older, empaths realize that other people don't enjoy being
around them, especially strangers. As a result, they tend to withdraw into
their worlds and become more focused on their problems. When these
feelings overwhelm, empathic people can become shy or frightened around
others and avoid contact. They may stop seeking friendship or company as
an escape, often retreating into solitary pursuits such as painting or writing
poetry. They may even stop reading altogether.

Highly sensitive empaths can be incredibly insightful and see the world
differently from most people. Their sensitivity is not a personality flaw but
rather a unique and extraordinary trait.

The traits that Highly Sensitive Empaths possess are an evolved survival
mechanism that has been passed down through thousands of years of
evolution. Their senses are so keenly focused on the world around them that
they can detect dangers such as impending tornados or earthquakes before
anyone else. They can sense when a loved one is sick or injured, which is
why they can be incredibly nurturing people who strive to help others with
their emotional and physical needs. Highly sensitive empaths may have
difficulty working in environments with fluorescent lighting, computers, or
loud machinery.

Empaths are not Highly Sensitive Empaths; they do not experience every
feeling of everyone that comes into contact with them. Due to these
characteristics, Highly Sensitive Empaths find it difficult to develop their
feelings because they always seem to mirror other people's feelings rather
than have their thoughts.

Characteristics of a highly sensitive person:

1. Easily overstimulated.

This trait is often mistaken for shyness. It's not so much that a highly
sensitive person can't talk to people. It's just that after a long day of
socializing, they may need to go home and take a breather before reaching
out to others in person or online. To expect this behavior from their friend
or other empathic people, a highly sensitive person might view the highly
sensitive person as rude or weak-willed. Although it is unrealistic to expect
this behavior from every highly sensitive person, if a highly sensitive person
says they prefer being alone and need some time to themselves before
talking with others, they should not be judged for it. Other empathic people
need to understand that it is ok for a highly sensitive person to need some
alone time.

2. Forgetful

This trait is probably the most frustrating for friends and loved ones of a
Highly Sensitive Empath. Often, a Highly Sensitive Empath will forget to
call back a friend or family member who has left several messages for them.
This is not because the Highly Sensitive Empath doesn't care about their
friend or family member; they are so absorbed in what they are doing that
they forget to call back.

3. Feelings easily hurt

Most empathic people find other people's words and actions incredibly
blunt, but Highly Sensitive Empaths take everything people say to heart. It
is not normal for a Highly Sensitive Empath to read a text message or email
that someone has sent without physically feeling the pain. To make matters
worse, empathic people are more likely to be hurt by their feelings than
others. Often when someone says something hurtful towards them, it is not
because they are angry but because they are hurt by what they have just
heard. Additionally, when highly sensitive person is hurt by their feelings,
they will often avoid social interaction entirely out of embarrassment and
confusion.

4. Easily deceived

This trait may be heartbreaking for family and friends who deal with an
empathic person daily. Empaths are incredibly selective when it comes to
choosing their friends. Many people will be completely unaware of how
loyal and nice a person they genuinely are. For this reason, Highly Sensitive
Empaths choose to surround themselves with only other empathic people
because they can't tolerate the feeling of being deceived by non-empathic
people. The final thing that makes this trait so hard on a highly sensitive
person is not knowing how to deal with their emotions and fears. People
who have never experienced Highly Sensitive Empathy cannot understand
what it's like for a highly sensitive person to be afraid of others' feelings,
especially when they cannot figure out why they feel the way they do.

5. Trusting

Because Highly Sensitive Empaths are so easily deceived, they find it very
hard to trust others. They are unaware of how they can seem judgmental
towards people around them, and it isn't until they've been hurt that they
realize that the root cause of all their problems is caused by the inability to
trust other people.

6. Gets too involved in others' feelings

Often a highly sensitive person will feel the same feelings as another person
in an attempt to understand what that person may be going through. This
trait goes against being empathic, in which a highly sensitive person should
be able to sense how they are affecting other people but not take that
knowledge and use it against them. This can be extremely difficult for other
empathic people who also want to avoid being hurt by others' feelings and
understand those feelings better.

7. Helpless

Many empathic individuals have found that a great deal of the growth in
their personal lives has come from developing tools to cope with the
situation instead of waiting for someone to swoop in and rescue them. To
help themselves better, they may think of ways to help others find their way
out. This trait is extremely hard on Highly Sensitive Empaths because they
can't cope with many emotions around them. They may find themselves in a
situation where they are surrounded by people who are angry and arguing
but have no desire to intervene because they don't like conflict and don't
know how to deal with it.

8. Cannot take compliments

Highly Sensitive Empaths can barely accept compliments from others

because their minds are so focused on what they feel that they cannot
recognize their self-worth.
9. Gets drained easily

It's not uncommon for a Highly Sensitive Empath to feel drained after social
interaction because of how much they absorb from others through their
empathic nature.

10. Cannot read others' thoughts or emotions

This trait is probably the most frustrating for those close to an empathic
person because there is no way to communicate with a highly sensitive
person about the situation if it is true. It's important for other people who
don't know what it's like to be an empath to understand that this trait can
make a very painful situation even worse for those who are Highly Sensitive
Empaths.

11. Cannot tolerate intense or loud sounds

It's normal for most people to get overwhelmed by the sounds of a big
crowd, but for a Highly Sensitive Empath, that feeling of being
overwhelmed is so intense and painful that they cannot stand to be in large
crowds.

12. Extremely Creative

Highly sensitive people take every aspect of their surroundings, and their
world becomes filled with intense emotions. Because of this, they are highly
creative people who enjoy the arts. It's common for an empathic person to
want to become a writer or an artist because it gives them the chance to
express emotions through art.

How to be more empathic

Everyone is empathic. We can all be sensitive to our feelings and those of
others around us. Yet, this capacity to feel is one of humanity’s most
precious gifts and one of its most fragile.

Most people strongly sense that empathy is good and that its presence in
others helps ensure the well-being of society and our relationships. But
many believe it’s a burden that may be better for society to do without
because its effects on behavior are too unpredictable and difficult to control.
Empathy is also a delicate thing to acknowledge, as it can take a long time
to develop and requires us to put ourselves in another’s shoes. This can be
difficult for many people who may have been socialized (or bullied) into
thinking that their feelings are peculiar or wrong or that their motives are
suspect. It’s not enough to say, “I’m empathic.” We need to work at this
with care and awareness that we can make mistakes.

Another reason empathy can be hard is because empathy needs more than
just the ability to observe our feelings from someone else’s perspective.
Instead, we need to allow ourselves to feel the other person’s reality and to
be capable of acting with that in mind.

This can take practice, self-care, and continuous reflection on our feelings
toward our fellow human beings. It is not easy because empathy is a highly
sensitive skill than can be developed but also requires great strength,
endurance, and courage.

If you manage to open up your heart and mind to feel what others are
experiencing, it can become overwhelming at times. The chasm between
your and their feelings may seem too wide for you to cross without losing
yourself in their suffering. It can be easier to close down by withdrawing
from the person and their problem.

We all have this capacity to shut down if we feel overwhelmed, especially

those of us who have been hurt or shamed during our childhood for
expressing our feelings. So understandably, trying to be empathic when so
much suffering around us may sometimes seem worth it. Still, if we don’t
allow ourselves to feel, then we can only protect ourselves in a very narrow
way, and we run the risk of feeling isolated and alone ourselves.

There are many ways you can build up your capacity for empathy.

* Take time to reflect on how you feel in your own life. Pay attention to the
feelings that come up when you’re in different situations and work out what
makes you feel good and what makes you feel bad. When we don’t look
deeply at our own lives, we take on the lives of others without really
understanding where they’re coming from.
* Try to be aware of your motivations for doing things. For example,
sometimes, we try to be good because we want others to like us or because
it makes us feel superior. Little by little, try and look deeper into why you
behave like this. Give yourself a chance to know your reasons for being the
way you are.

* Think about the people in your life and their life. This can be especially
useful if you are in a potentially toxic relationship, but whatever the
situation, a little more empathy goes a long way. We’re all more alike than
we think, and even when something feels very personal, it’s often driven by
outside forces we know little about.

* Learn how to help someone in pain by noticing and directing their

attention where they need it most. This may involve a great deal of practice
and skill, but there are many ways you can learn how to help another
person who is suffering. For example, consider volunteering for crisis
hotlines or doing online searches for other ways you might help.

* Work on the relationships in your life and be aware of how you’re feeling
at different times with each one. You can also try to notice how others feel
about your relationships to see if any overlap or similarities can be
addressed healingly.

* Take time for yourself to do things you enjoy doing, as well as try and put
yourself in other people’s shoes when you are out in the world. This will
help you to see other people’s feelings as clearly as your own. You’ll be able
to identify how others feel when things happen and how they think about
the ways that they might behave in response.

* Being empathic needs more than just a set of basic skills; it is possible to
allow yourself to feel another person’s emotions deeply and at their deepest
level, with no limits on your ability to act on them. This isn't easy, but it can
be a real gift if you can get there.

* Remember that empathy is not a skill you’re born with; you can develop it
over time. But just as with any other skill, if you don’t practice regularly,
the muscles weaken, and your capacity to feel less. So to hone and maintain
your empathic skills, work on them everyday in some way.
* Work on your self-care to ensure you have the resources you need to give
from a space of generosity and compassion rather than from a place of
vulnerability and fear.

* Don’t be afraid to reach out for help when you need it. You can learn much
about yourself by working with others on your empathic skills, but
sometimes it just isn’t enough on your own. Seek counseling or support
groups, or find an empathic friend who will listen as often as possible. You’ll
feel better about it.

* Remember that empathy is not about feeling guilty about it but rather
about doing something you care about with your whole heart and soul.
Therefore, empathy is always a choice. This means we don’t have to feel
uncomfortable or guilty if we don’t feel empathic toward someone – it just
doesn’t suit us right now.

* If you find you’ve shut down your empathy because it feels too intense to
live with, remember that you can turn it back on again. You’re not stuck like
this or missing out on something special by doing so. It doesn’t matter how
long it takes for you to be able to reach out with empathy – the important
thing is that you keep trying to live in a way that is truly in line with your
values and who you want to be.

* If you want to experience a moment of feeling in your heart that feels like
empathy, try a silent meditation in which you allow all thoughts and feelings
from your body and mind to wash over you. This is a wonderful way to
expand your sense of compassion and connectedness with the world.

The ability to be emotionally intelligent means being able to make the best
judgments about people, events, and situations based on how they make you
feel. It involves adapting your behavior in light of how others feel and
understanding how they feel regardless of whether they show it.

In essence, emotional intelligence can be considered an ability to see things

through another person's eyes.

Emotional intelligence is what allows us to read the feelings and

motivations of others, and it is a huge factor in whether we can build strong
and lasting relationships or not.
The development of emotional intelligence follows a similar progression as
that of simply being empathic. However, whereas empathy is about giving
to another person, emotional intelligence involves giving to yourself.

Without the right amount of self-awareness or the ability to make choices

based on our inner wisdom, we cannot see things enough through
somebody else's eyes. We can't see ourselves or ourselves in others, so we
can't see what is going on.

The following provides a basic outline of the stages involved in becoming

more emotionally intelligent. Note that this isn't a step-by-step guide for
how to develop emotional intelligence but rather a discussion of the various
facts that are important to know about this skill.

* Learn how to understand and use your feelings effectively. This takes
practice and can be hard, especially when you're in an emotionally charged
situation. But once you feel like you're getting closer to understanding
yourself, you'll find your feelings don't surprise you anymore and are easier
to understand when another person is feeling them too.

* Learn to notice the feelings of others. The things we do and say when
we're feeling emotionally intelligent are completely different from what we
do and say when we're not. So when you notice how other people are
feeling, you'll better understand what they need or want from you or the
relationship, which will help you further refine your emotional intelligence.

* Learn to understand your feelings concerning those of others. This is

about constantly checking in with yourself about how you feel and why you
feel that way so that your emotional intelligence doesn't go out the window
when it's no longer needed.

Empathy offers us a chance to be fully human. It can be a wonderful gift and

one of the most precious things we have as human beings. It’s not easy to
develop this quality but trying may offer us a chance to bring more joy into
our lives and those around us, so it’s well worth working at it.

The 5 steps of emotional intelligence.

Emotional intelligence is the awareness of and reaction to one's emotions
and those of others.
Empathy is the ability to understand and share another person's feelings.

Intuition is the ability to sense a person's thoughts or feelings without any

formal logical reasoning or prior experience with that individual.

Psychic abilities are supernatural mental powers/abilities with no scientific

proof or evidence.

Some people have psychic abilities like ESP (extrasensory perception).

These five steps will train you to be an empath so that you can focus on
emotions not just of yourself but also those around you and help make life
easier for everyone through understanding their own emotions better -
developing empathy for others.

Psychic abilities are the skills for empaths to pick up on feelings, emotions,
and thought forms from different energies.

The 5 steps of emotional intelligence:

Step 1: Being aware of your own emotions.

This initial step is critical, but it cannot be easy. Just observing your feelings
and finding out what you are experiencing can help you identify your
emotions and also help you understand others more. Moreover, you
sometimes ask yourself why this person is behaving the way they are - in
which case paying attention to your own emotions can give clues about
other people's emotional reactions.

Often, our first reaction to a situation is emotional and not intellectual.

Identifying our first reactions can help us understand others' actions better.

Tip: Journaling works very well for people who have trouble connecting with
their feelings. Writing down everything you think, feel, and sense helps you
process your thoughts and feelings and learn new things about yourself.

Step 2: Being aware of other people's emotions.

"Smiling is an outward expression of inner happiness." - Sigmund Freud.

Once you have your own emotions under control, you can start paying more
attention to others' emotions and adjust your actions on the fly depending
on their emotional state.
Tip: Often, other people's emotions are based on their past experiences or
those they have witnessed and understood only through their relationships
with others. Sometimes people's behaviors can be the result of their
feelings about themselves or the world in general for example; if a person is
feeling too much fear or anger, it may manifest in some form of physical
violence at someone else as another body shows signs of survival instinct
due to fear and anger.

Step 3: Develop your intuition.

Building on the awareness of emotions, you want to develop your intuition

which is the ability to sense thoughts and feelings that the person does not
express. You can develop this ability by setting aside time where you are
clear of distractions and focusing solely on your surroundings or training
sessions. Concentrating on a sound, feeling, thought, or event surrounding
you, you will notice small details that feel familiar, and new things will come
to mind when focused on certain things.

Tip: Allowing yourself to be more open about your emotions can help with
this step. Once you start feeling more comfortable in yourself, you will be
able to allow feelings to flow more freely, and your intuition can pick up on
these feelings and aid you in understanding others better.

Step 4: Use psychic abilities.

Psychic ability comes from the word psychic, which means "about the
psyche." In this sense, it refers to any ability that allows them to perceive or
interact with thoughts and feelings not expressed by the person.

It is important to remember that psychic abilities can lead to negative

outcomes if the communication between an empath and the person with this
ability is not established.

Tip: Developing these abilities does not have to be done alone. Help from
others can greatly benefit both parties. Also, the more you do it, the easier
it will become for you.

Step 5: Use feelings/emotions as a tool for understanding others.

This step may seem like an obvious one. Still, many people take an
emotional approach based on ignorance and greed instead of their own
emotions and those of others. They rely on them as a tool for understanding
others better, thus making life easier for all involved.

This is the key step to becoming an empath because recognizing feelings

and emotions as tools rather than feelings to be ignored will help in being
more receptive to others.

Tip: Emotions are often used in stressful situations as a barrier to

communicating with others but understanding how a certain situation
affects you and how you react emotionally can be very helpful for those you
seek advice from.

Empaths are seen as "healers" because they can understand others' feelings
and be very empathetic but being an empath doesn't mean you have to heal
people or fix them. The point is not to heal people but to learn how they feel
so that you can understand them better and see their point of view easier.

It would be best to never decide how other people should act based on your
emotions. However, it is a good idea to know how someone else feels
because this will increase your understanding of the other person and help
you improve communication with others in the long run.

Sometimes, empaths feel that their emotions control them because they can
be so intense and overwhelming - but with practice, you will gain more
control of your emotions, so it's possible for empaths to live a normal life.

You can also use your skills to protect yourself from emotional attacks from
others. By understanding the emotions of others, you can learn how to not
let other people affect you emotionally and how to deal with them in a way
that makes the most sense. Emotional intelligence skills are the foundation
of being an empath. They should be integrated into life daily by paying
attention to your emotional needs and those of others around you.

Being an empath is one of the most rewarding and significant things one
can do if one chooses to learn and apply these skills. They can help you
better understand people as well as yourself. This understanding will open
up many opportunities for you to interact with people in ways that benefit
both parties.
There are various ways to develop your empathic abilities, but the first step
is to be willing to put effort into understanding emotions and becoming
more aware of your surroundings. Empathy is a complex skill that requires
practice, patience, desire, and persistence, but once you have started down
this path, it will open up many more possibilities for yourself.

Emotional intelligence stages are essential since they can develop their
empathic abilities and better relationships with others through them. Once
you realize that emotions are tools to be used and not something to be used
against yourself or others, you will attain a greater level of understanding
regarding how others think and feel.

Emotional intelligence is the ability to understand your own and others'

emotions, accurately read and feel them, and comprehend other people's
emotions. Empaths have a strong sense of empathy for others, which is an
essential part of their daily lives when interacting with others. Therefore,
developing your empathic abilities will greatly help you understand
yourself.

With that being said, there are many ways in which you can improve your
emotional intelligence skills or develop them further if you already have a
strong understanding of what it means to be an empath. The following are
common stages that can be used to better understand your abilities and
improve your relationships with others.

Many people undervalue their empathic abilities as a part of their overall

emotional intelligence. If you feel that you may be an empath, then it is
important to give yourself a chance to understand these skills and work on
them to make the most out of them.

Some people cannot empathize with others, meaning they cannot feel
another person's emotions. However, this is one of the most basic forms of
empathy and the most easily developed for those who wish to improve their
empathic skills. Hence, it is worth considering before dismissing your
abilities as weak or worthless.

There are many ways to develop your empathy skills so that you can feel
more confident about your abilities and be able to better understand the
emotions of others with practice and patience. The above stages are
designed to help you better understand yourself as an empath, but there are
many different methods of developing these skills, so if you don't quite
agree with the stages above, that's fine as long as it works for you.

Suppose you don't think you're an empath yet but want to become one. In
that case, it is important to consider practicing emotional intelligence by
accepting that everything around us is connected on some level and that
whatever happens affects us deeply. Many people think it is unusual or
ridiculous to feel something for another person or even empathy for
another. Still, the reality is that this is how life works.

Once you have accepted your ability to empathize with others, you will
better understand yourself and others. As a result, you can understand the
human experience on a deeper level and move forward in your personal and
social growth.

How to find yourself and heal from empathic stereotypes

Are you highly sensitive? Do you often feel overwhelmed with the emotions
and physical sensations of those around you? Do you take on everyone’s
feelings as your own, even when it is painful or uncomfortable to do so?

If this sounds like you, then chances are that at some point in your life,
someone has called you “too sensitive,” “too shy,” or “just too much.” They
may have told you that if only you could be more like them, then life would
be easy, and they would have much less work to do. But it doesn't have to
be this way.

High sensitivity is not a handicap. Instead, it can be a gift - a tool that

empowers you to get in touch with the world around you and see it as it is.

1) You are unique

Some people find it difficult to believe that every person on the planet is
different. They think something must be wrong with those who cry at
movies, have difficulty in social situations, or can feel their friends'
emotions so acutely. They think we should all be alike and like them better
than they do.
But when they hear that just about everyone feels different, they are
relieved that maybe there's nothing wrong with them.

2) You can feel their pain

After all, if everyone else is sensitive, why can't you? The answer is that
everyone can feel another's pain - but some people are more sensitive to it
than others.

Having a heightened sense of empathy allows you to feel the emotions of

others deeply and to sense the other person’s suffering as though it were
your own. It has also been shown that highly sensitive people can detect
subtle changes in facial expressions, body language, and tone of voice,
enabling them to understand another person's emotions accurately.

3) You have depth

In the long run, empaths often report that they are happier and healthier
than others. Being highly sensitive is not a disadvantage. On the contrary, it
can help you to:

• Have an increased awareness of your emotions and feelings and those of

others.

• Be more creative as you live life more intensely.

• Become a healer, providing compassion and love to others in need.

Coming to terms with the fact that you are different can be very liberating!
You don’t have to pretend or win points to impress someone or fit in. You
are born with sensitivity, the noblest thing you can be. It is a gift that you
can use to help others, heal yourself and make your life rich, meaningful,
and full of joy.

Understanding your sensitivity can create more harmony in your life by

developing a more balanced perspective. For example:

• You often feel what others feel because you need human connection to
survive, so it's healthier for you to accept this as part of your reality.

• Your empathic nature means that you are empathic to all people, not just
those with similar experiences or needs like yourself.
• You are more likely to have less self-esteem.

As you can see, there is nothing wrong with sensitivity. Emotions are about
connection and healing. They are a natural part of our existence, but
sometimes this is not obvious to those around us.

The key is learning how to accept ourselves and how we experience the
world.

Empaths who have accepted themselves as they are reporting that their
lives are better because they have learned to live in their truths and express
themselves freely.

One of the most important things you can do is to surround yourself with
people who accept you and appreciate your sensitivity. Try not to put too
much pressure on yourself, but if you find that others’ expectations are
getting you down, speak up for yourself.

4. You are not damaged

Divorcing yourself from your sensitivity is a common coping strategy played

out by all people, not just empaths.

Many people who feel more sensitive to their environment often act in ways
that are perceived as ‘weird’ or ‘different.’ For example, this may involve
wearing dark colors, listening to sad music, and reading books with deep
themes.

Empaths sometimes experience their sensitivity in a powerful,

disempowering, and unhealthy way (for example, by feeling too
overwhelmed by other people's emotions to have a healthy relationship with
them). This can make some people think they are not okay and should be
fixed.

But this is not the case at all. Empathy is a natural response to being alive.
No one is damaged because they feel what they feel.

5. There is no right or wrong way to be

As you can see by now, being highly sensitive means being in touch with
your inward self. This means that you are more reflective and sensitive to
your environment, traumatic or otherwise. But contrary to popular belief,
this is not a weakness; it’s strength and resilience in the face of suffering
and pain and human suffering.

Highly sensitive individuals are often not the ones you'd usually think of as
'strong.' Still, they can cope with adversity in their lives because they have a
well-developed ability to feel pain and express it.

6. You can still be good friends

You will find that empathic individuals experience more guilt, shame,
anxiety, and depression than normal people. However, highly sensitive
people often report that when they feel this way, they can focus on healing
themselves while still being part of a healthy relationship with their loved
ones. In addition, they tend to be more insightful and supportive of other
people than their less sensitive counterparts.

And have you noticed how much easier empaths find it to forgive than other
people? It's because they better understand why someone did something.

7. You are not alone

Like I said in the beginning, it often appears that most people do not feel
what you feel, making you feel like the odd one out. However, despite not
having many empaths around, we are increasing.

We each have a different flavor, making our community unique and strong!
But if you're like me, you may still doubt yourself. This is normal. Especially
with something as sensitive as empathy, it can be hard to believe that we all
are the same in this community.

Despite our differences, all empaths experience the same emotions, even if
they express themselves differently. So when you feel down or lonely,
remember that although your feelings may seem overwhelming, they are
completely natural and part of the human experience. You are not the odd
one; only your intuitive, empathic abilities set you apart from others!

8. You can do something about it

If you have read this far, then you are probably convinced that being an
empath is not a bad thing. Sure, sensitivity can cause some problems in
your life, but knowing and accepting that you feel more deeply than others
is the first step in changing how you deal with the world to become a more
effective empath.

It only takes small steps to change how you use your empathy. Therefore, it
would be best if you accepted yourself as an empath before building on this
acceptance and integrating it into your daily life. For example:

• Accept that it takes time for you to make friends – don't feel like there's
anything wrong with you because it happens so much.

• Stop beating yourself up for expressing your emotions so intensely.

Instead, accept that you only do this to help others and yourself.

• Start with small changes. For example, tell yourself: “I can cope with the
fact that I only want to talk about one topic” or “I can cope with feeling
overwhelmed when talking to some people.”

• Read a little more about how empathy works and how you can work with
it better in your life!

9. You don't have to be like everyone else

Empaths are the most loving, caring, and sensitive people on this planet and
some of the strongest and most courageous. But don't think having these
qualities means you have to fit a certain persona.

You can be yourself and know that others are like you. You can love your
unique way of being alive!

Remember to take small steps to change your life to feel more empowered
when dealing with others' emotions. And remember that you are a
wonderful person for being so honest and strong!

10. Be true to yourself

Being an empath means accepting that you feel more deeply than other
people in response to your environment. As we have seen, people who fall
into this category tend to experience:

• Anxiety and depression

• Feelings of loneliness and isolation

• Anger and frustration

And yet many highly sensitive people show great strength and courage in
facing these challenges. This is because they can channel their sensitivity
into something powerful – empathy. Acknowledging that you are a highly
sensitive person is the first step in changing how you deal with the world so
that your sensitivity becomes an effective part of who you are.

Strategies to calm your senses and cope with pressure.

The Highly Sensitive Empath (HSE) is a type of empath with heightened
senses. HSEs have an increased awareness of their surroundings, which can
be overwhelming and overwhelming enough to send them into a downward
spiral.

This book provides several strategies for balancing your sensory

experiences, managing anxiety, and taking care of yourself when
surrounded by people who don't understand your sensitivity level. The
author also lists empathy skills anyone can use to make themselves feel
better in these difficult situations.

HSPs are often called Super Sensitives because they have enhanced sensory
perceptions and usually very high empathy levels- meaning that one thing
they feel intensely is other people's emotions and needs.

Because of this, many HSPs find social situations to be very difficult, as well
as people. However, there are many ways that a highly sensitive person can
make themselves feel better during social situations, from learning to be
more comfortable with uncomfortable emotions to developing the skills of a
better listener. Some of the points in this book are useful for anyone, but
HSP tendencies make it very important for HSPs to learn how to deal with
these problems.

It's a misconception that HSPs are shy or even anti-social. This isn't always
true, but many people think this because they assume everyone else is
comfortable with things they aren't. They assume that all non-HSPs can
handle going to large gatherings of people and being bombarded with
different emotions, having certain smells in the air, and so on. This is not
true, and HSPs need to realize how many people are like them and feel the
same way they do.

Social anxiety disorder is a condition many highly sensitive persons suffer

from, but it's not classified as any anxiety disorder in the DSMIV
(psychiatry).

The difficulty that HSPs have in social situations results from having
heightened senses, typically meaning an increased amount of empathy and
other "energy" that can be overwhelming or unbearable. The DSM-IV lists
17 disorders involving excessive shyness, such as a social phobia. These are
social anxiety disorders, and being highly sensitive does not fit these
criteria.

Sensory processing disorder is a condition many HSPs suffer from, but it's
not recorded in the DSM – IV (psychiatry). Therefore, there is no test for
this, but it can also be treated by adjusting one's sensitivity levels.

Various strategies are useful in making HSPs feel better. These strategies
can also be useful for any person, but they're especially helpful for social
situations that may be difficult or make people uncomfortable.

Everyone has a different level of comfort in their skin, and there's no way to
make yourself not have those feelings. However, some strategies help you
become more comfortable with your and everyone else's skin.

Several of the points in this book focus on the idea of being a better
listener. Think about what you're saying before you say it (try to pause
before responding), and ask questions rather than telling people what to do
or how to live their life.

The strategies for calming your senses and coping with pressure include:

1. Using a technique called "neurobics" or "neurotunes."

Neurobics or neurotunes are ways to stimulate your senses in a new way.

For example, you can use music, art, or any other kind of activity that help
you feel new things.

2. Focus on your five senses.

As an HSP, you are very sensitive to the world around you and yourself and
what's happening inside you. So when you're in a social situation that isn't
exactly fun, it's best to focus on your emotions and body for a little bit
before going back into socializing mode again.

3. Finding new things is beneficial for everyone.

Finding new things can be beneficial for everyone. Even if you hate pink, it's
good to think about what day's color might work for you. Whether shades of
blue or green, many colors worldwide are good for people with HSEs to find
comfort.

4. When everyone else is listening to music, use earplugs or turn them

down.

When everyone else is singing and dancing in their way, you can use
earplugs or turn them down so that your sensitive ears aren't being hurt by
the noise from all of their songs and activity.

5. Don't make everyone feel bad for their problems.

If you're having a bad day or a hard time, don't talk about how things aren't
fair or how "you hate the rain." Everyone deserves to feel good about
themselves and where they come from.

6. Go out at night and find something that interests you.

Even if it's just watching the sunset, this is a positive thing for everyone to
do because it makes people calmer and happier.

7. Be happy for every moment you have together.

The next time you're in a social situation, be happy for the moment – even if
it's not perfect.

8. Don't worry about other people's reactions to you.

It's normal for people to have strong reactions when someone is different,
but please don't worry about what others will think of you when they see
you or how they feel about you. Moreover, HSPs need to be aware of what
other people are feeling – even if it's scary or sad.

9. Wear colors that make you feel comfortable.

Wear colors that make you happy and feel good about yourself. This can
make you feel happier and more confident than just wearing colors because
everyone else is wearing them too.

10 . Avoid social situations as much as possible.

If you don't like being in social situations, try taking a break or trying to
avoid them altogether so that your mind doesn't get hurt from being
bombarded with emotions and senses all at once.

11 . Leave the area if the situation is too much for you.

Before you attend a social gathering or any event, try to prepare yourself
for what might happen and what will be happening. Sometimes it may just
be too much to handle, so don't feel you have to go unless you want
something out of the experience.

12 . Do things that make you feel good about yourself.

If there's something that makes you feel good about yourself, and it's within
your budget, then by all means, do it and feel great about it!

13 . Find a way to relieve stress in your life.

Try finding a way to relieve stress in your life – whether taking a break from
social events or getting out of the house for a little bit. There are many
different ways for you to take care of yourself and feel good about what
your body needs.

14 . Be realistic about how much you can do.

Please don't overdo it when trying to be social with other people because
sometimes being too social isn't fun. Also, try to have realistic expectations
about yourself and everyone around you since they are all different people
with their struggles and triumphs.

15 . Don't feel guilty if you need help.

If you need help with an event, don't hesitate to ask for it. It's okay to need
help sometimes!

16 . Keep the environment around you clean and tidy.

Keeping your environment clean and tidy can help you feel more
comfortable with people. On the other hand, a messy or dirty environment
can hurt your senses, so take the time to clean up or organize things before
a social engagement.

17 . Remember that everyone has different opinions and may not be right.

Remember that everyone has different opinions – even if they're right in

your own opinion, it doesn't matter because their opinion is just as valid as
yours (or anyone else's).

18 . Don't be afraid to leave a social event or situation if you're

overwhelmed by it.

No one will blame you for being unable to handle something, so leaving a
social event or situation is okay if you need to calm down and feel better
about yourself.

19. It's okay to talk about your feelings with other people.

It's normal for HSPs to have problems with creating distance between
themselves and other people. Still, they need to figure out how they can be
involved in more groups of people without overexposing their emotions and
senses at the same time.

20 . Find the balance between being in a crowd and having space for
yourself.

Find the balance between being in a crowd and having space to yourself by
going to different places or trying new activities instead of repeatedly doing
the same old things.

21 . Don't put too much pressure on yourself because it won't make you
happy.

Everyone must remember that they deserve as much time as they need, no
matter their emotional issues. Trying to push yourself too hard to be social
doesn't help anyone – even if you're trying to help others or your self-
esteem.

22. Don't use alcohol or other substances as a way to feel better.

Drinking alcohol and taking drugs will only encourage you to do more and
more things that aren't good for you, which will end up hurting your mind
even more in the long run.

23. Always keep your number of close friends at a minimum.

If there is someone who tries to be your friend when you don't want them
around, then it's okay to log off of social networks and focus on the people
you already care about because they're the ones who will make you feel
better anyhow.

How to overcome anxiety and worry and develop social skills

when you are a highly sensitive empath.
It's easy to become anxious, discouraged, and doubtful when the people
around you seem confident, calm, and happy. You know something is wrong
with that picture, but you can't put your finger on it. It's like always being
the only sober person in a room full of drunk people. Their voices and
actions are unclear; you can't make sense of anything.

What is it that separates you from the rest? Most people seem confident,
outgoing, and friendly, but you feel different. You might say shy or quiet if
asked, but inside, you're anything but those things. You may have even been
told that you're arrogant or stuck-up because you tend to laugh at others'
foolishness, and when they don't understand your witty humor, they get
offended. Well, I'm here to tell you there is nothing wrong with being
superior in intelligence, wit, and morality. It's better than feeling like a fool
all the time because you become an imitator of fools.

That's not to say you're trying to be better than anyone else. It's just that
you perceive others differently because you see through their masks. You
know the difference between an authentic, sincere person and a phony. You
know what it means to be yourself, to have your unique style, sense of
humor, and taste in music. This can make it difficult for others to
understand you, but fortunately, your time is coming when the world will
realize how valuable you are and begin treating you accordingly.

First and foremost, know this about yourself:

You are a highly sensitive empath, and there is nothing wrong with that.

You have an amazing gift to offer the world because you can feel and see
things others cannot.

You can feel auras or energy nonverbally.

These are the only physical senses you have, so you can't see or hear the
world around you because you don't have eyes or ears. You must use your
other five senses to perceive the world. But even though you should never
try to stop being sensitive, it is good to learn how to conceal it from others
and dull your emotional sensitivity. This is especially critical for advancing
life and achieving your full potential as an adult.

If people are less emotional, they'll also be less judgmental and more open-
minded towards people different from themselves.

Your heightened sensitivity allows you to pick up on subtle energies and

feelings, thus giving you an advantage in terms of intuition and knowing
what others are thinking. This can be a great tool for being a writer, artist,
musician, or comedian.

There are positive ways in which your personality can develop. If you put
effort into it, your unique gifts and talents will shine through so that people
will come to appreciate them.

The best way to get started is by listing all the things that make you feel
uncomfortable about yourself.

Therefore, these tips can assist in overcoming anxiety and worry and
developing social skills when you are a highly sensitive empath:

1. Realize that being different is a gift.

This will make you understand that you're in a position to influence others
and add something missing from their lives. In addition, you'll also see that
it's not a weakness to be different but a strength.

2. Avoid negative people.

Know that you can only influence the world around you by being positive.
Therefore, it's best to avoid negative influences because they will always try
to pull you down with them. Unfortunately, there are times when you will
have to put up with people who don't like who you are and even try to turn
others against you. People like these are jealous because they wish they
could be as confident as you. You might not understand it now, but when
the power of your personality shows through, they will come to respect you
and ask what they can do to get in on your good karma.

3. Be proud of the things that make you feel insecure.

These are your strengths, and you should appreciate them because they
make you who you are. Instead of trying to change yourself to fit in with
other people, never forget how special you are as a person. For example, if
certain things, such as loud noises or too many people in a room, bother
you, it will be good to acknowledge this because no one else needs to know
that they do. This can keep your sensitivities under wraps instead of having
people constantly tell you how funny it is when something bothers you that
doesn't bother them at all!

4. Learn to embrace your differences rather than trying to hide them.

It would be best if you never tried to conform to the norms of society. This
can lead you into a life of regret and unhappiness. The more you try to "fit
in," the more likely you will become a conformist. Unfortunately, too many
people try to be as dramatic, loud, and different as you are but often
become frustrated with their lives because they can't live up to their
expectations.

5. Don't let others label you.

You don't need people to define who you are. Make it your mission to set the
boundaries of your personality, and don't let others step along those lines.
Even if they try to do so, stick to your guns by telling them that you can only
be yourself, so there is nothing wrong with who you are and what makes
you unique. You feel these things, not things others decide for you.

6. Create a strong sense of identity.

Do what makes you happy, but remember that developing a strong sense of
self-worth is important. Without a strong sense of self, you will think that
your personality is not good enough, and you will doubt yourself. This will
make you feel inadequate and cause stress in your life.

7. Don't be anxious or afraid when you're around others.

Don't let other people control your emotions by bringing up things that
bother you. If they say something to upset you, answer them with a
question, "Why do you think I'm going to be upset?" You don't have to agree
with their reasoning but answer them with a firm concern for their well-
being because it's obvious they're worried about what you're going to do or
say.

8. Forget what people think of you.

Ask yourself: "What would I say if they asked me this?" For example, you
can say a question to someone and then answer it yourself. You can have
different opinions; your opinions don't have to match everyone else's. This is
a good way to make yourself more confident in your personality and other
people to better understand how you feel about things.

9. Let everything go.

Don't hold grudges or be upset about things that happened in the past.
Instead, please focus on the present because it's vital for growth.

10. Be your own best friend.

Be your cheerleader and give yourself a lot of self-love. Building self-esteem

from within is important because this is the only way to truly believe in
yourself. As soon as you feel confident in who you are, other people will
notice and be attracted to you because you can share your inner beauty
with them.

11. Take care of yourself.

Spend time caring for your basic needs such as eating proper meals,
exercising, getting enough sleep, etc. If you fail to care for yourself, you
may think you can't achieve anything. Of course, this isn't true, but it will be
harder to be positive and happy if your physical body is not in good shape.

12. Get enough sleep.

You will wake up feeling refreshed and less stressed if you get enough sleep
at night.

13. Be tolerant of others.

You need to realize that not everyone has the same level of sensitivity as
you do, so they will not act or react the way that you would if a situation
arose. This doesn't mean they have bad intentions because people have
different ways of doing things based on their personalities, morals, cultural
beliefs, and values. If you are honest and respectful, then others will be too.

14. Be a good role model.

Think about how you want to be seen by others and make sure you live up
to that ideal. If people think of you as a super-human who can do more than
anyone else, they will automatically look up to you. Suppose they see you
walking calmly with confidence and even having fun in front of them. In that
case, they will feel comfortable around your personality, which is the only
way to establish a good reputation. Otherwise, people might take notice of
your behavior due to their judgmental nature but not because they like it or
respect it, so they treat you differently because of it.

15. Know your body and know your feelings.

Don't overeat because you think that you need it. This can lead to gaining
weight unnecessarily, making you feel self-conscious and causing health
problems. You should also think about how many hours of sleep you want
before going to bed because this is important for good health, not just for
the physical part, but it also affects the mind and will enhance your energy
levels for other things.

16. Have realistic expectations.

Life is unpredictable, so don't expect the world to change overnight.

Instead, start small and work towards a specific goal instead of expecting
overnight success.

How to create a peaceful work environment.

If you are highly sensitive, it cannot be easy to work in an environment that
isn't pleasant. It's not uncommon for highly sensitive empaths to experience
difficulty concentrating, depression, and anxiety that can lead to problems
at work.

If you're an empath, it's easy to pick up on the negative energy of others,

which will make you feel like your workplace is less than ideal. When you
have a highly sensitive personality, you will feel more stressed out than
others, even if your work is just as hard.

How can you create an environment where everyone is happy and healthy?

The following are some tips you might find helpful to help create a peaceful
and positive working space so that you may focus better on the task at
hand.

- Clean the office with natural products such as lavender or pine oil. This
helps remove any negative energy left by others, so your mood stays happy
and positive.

- Consider wearing a calming scent like lavender or peppermint oil while in

your office. - Get rid of any unnecessary messy, or distracting items on the
desk.

- Use a meditation room at work. Having a quiet place where you can
concentrate and relax is beneficial to help shift negative energy from your
workplace.

- Try meditation, breathing exercises, yoga, and aromatherapy to focus on

the present rather than thoughts about the past or future.

- Meditate for at least five minutes at a time.

- Comfort yourself with lavender oil or vanilla oil when you find yourself
feeling overwhelmed.

- Be mindful of what and how much you eat to avoid gaining weight.

- Eat healthy foods instead of caffeine and sugar, increasing anxiety,

nervousness, and tension.

- Avoid being near people who are in your personal space.

- Choose to be with people who are calm and peaceful.

- Put a "do not disturb" sign on your office door if you need peace. This
signal will help avoid interruptions when you work or study for short
periods throughout the day.

- Be polite with co-workers but don't be afraid to explain that you would like
to work quietly for a short period.

- Avoid spending a lot of time on the phone.

- Limit your interaction with people who are chatting, loud, or otherwise
disruptive. If you want to talk about something, chat about a quiet activity
such as sports or music.

- Take a break from work and gather your thoughts to refresh yourself and
relieve tension.

- Don't believe everything you think. Try to logically analyze your thoughts
instead of believing them automatically.

- Find ways to reduce stress in other areas of your life to feel more peaceful
and decrease anxiety while at work.

If this rings true for you, here are some ways to create a more enjoyable
work environment.

1. Make it known that you're highly sensitive

If your boss is a highly sensitive person and they know about your
sensitivities, it's easier to make the workplace feel more comfortable. This
may be as simple as telling them how you react to certain things so they
know not to bother you with those things. For example, if you get bothered
by the scent of perfumes or lotions, tell them that. It's better to tell them in
private than as a group.

2. Use a calming scent

Use lavender oil in your office if your work environment is too chaotic and
hectic. Even subtle scents of certain oils can calm an empath. If you're not
feeling any difference at first, don't worry about it because it takes time for
the effects to take place. Be consistent with using these scents so the
positive energy will last longer.
3. Create a meditation room

If you have a chance to create your very own meditation room, make it a
peaceful place for yourself. Use calming scents such as lavender, vanilla, or
peppermint oil to reduce anxiety and stress.

4. Practice meditation

Meditation can help an empath lower their stress and anxiety levels. During
this practice, you only focus on the present moment without thinking about
the past or future. You can create your little niche in the workplace so you
won't be disturbed daily. It's not about sitting in silence for hours but still
having quiet time where you can be alone with your thoughts and clear
them out before going back to work.

5. Eat healthily

To feel calm and relaxed at work, eating healthier foods is important,

besides creating the right atmosphere. Avoid junk and unhealthy food that
can increase anxiety and stress. Instead, feed yourself whole grains,
vegetables, and protein like fish to help stabilize your moods.

6. Be less rigid with your surroundings

You should work at a place where you won't be bothered by co-workers but
don't want to create an entire office environment controlled by rules just
because of being highly sensitive.

7. Keep in mind what and how much you're eating

Since you need to eat healthy foods, consider that junk food will increase
your anxiety and stress. Choose to eat healthier foods so that you stay calm
while at work.

8. Avoid being near people who make you uncomfortable

If you feel you can't concentrate in your workplace because of people

invading your personal space, avoid going to that place whenever possible.
Try to stay away from your co-workers as a way to create more space for
yourself at work.

9. Be less sensitive to disruptions

While it is great to be considerate of others, don't allow yourself to get all
upset if someone is being loud, disruptive, or distracting. You must
understand that people are different and can help you focus on your work.
Instead of getting stressed out, find ways to redirect your thoughts
elsewhere.

10. Be more open-minded with others

Don't be afraid to let others come into your life because it will not make you
any less valuable. Everyone is unique in their way, and despite the
inconveniences some people may cause, they still deserve your respect as
equals.

11. Be more open with yourself

This is about personal development. Take the time and effort to learn how
you can be a more compassionate person who cares less about society's
rules and wants to live more harmoniously.

12. Refrain from being rude

As previously stated, you want your co-workers to respect you. They don't
want to work with someone who is rude and doesn't appreciate them being
there while they are working. Some people may seem rude because they're
an empath, but it's just their nervousness talking, so don't be quick to judge
them as rude people just because they're sensitive.

13. Create boundaries with others

It's understandable to be private at work, but a fine line between privacy

and being too private can begin to be confusing. Try to create boundaries
with your co-workers so they know where they stand while trying not to be
mean or come off as rude.

14. Be honest with yourself

One of the best ways to reduce stress is by practicing mindfulness. When

you're hyper-sensitive, you're easily affected by the people and environment
around you, so it may take time to learn how to control yourself. That's okay
but don't get frustrated over being in this situation. Instead, accept it for
what it is and move on by practicing mindfulness daily.
15. Stay organized

Organized people know how important it is to remain calm at work. It's also
a form of self-care as much as caring for others. You will also strengthen
your creative side by being more organized so you can think more clearly
and prevent stressful situations from arising.

16. Avoid being reactionary

Being reactive can make you feel unstable in the long run and create a
sense of chaos when trying to concentrate in the first place. Try not to be
reactionary and practice patience, kindness, and tolerance at work or with
friends because that behavior doesn't benefit anyone during stressful times
like work.

17. Avoid resentment

It's okay to be disappointed in others for not meeting your needs just
because you're an empath. That doesn't mean you have to harbor feelings of
resentment against them. Instead, try to forgive and forget so that there
won't be any ill will between you and your co-workers.

18. Be mindful of how much time you spend online

Avoid spending too much time online as it can hamper your productivity and
cause stress because social media makes you compare yourself with others.
The next thing you know, you're getting frustrated with everything around
you, and the results are far from positive.

19. Avoid being too connected to your phone

When you're hyper-sensitive, it's normal to get attached to your phone.

Some people can't resist downloading new apps and games just because
they crave more information on the latest app or game release, but it
distracts them from the task.

20. Avoid social media

Social media can cause an overload of anxiety in the first place because
you're constantly bombarded with a lot of information that is not necessarily
helpful or necessary. You should avoid this kind of online activity whenever
possible.
The next chapter will discuss Vagus Nerve. This is an important piece of the
puzzle if you want to be more relaxed at work or anywhere in life. This
nerve is located in the brain that helps with controlling behavior. You can
easily become nervous or hyper-sensitive when your Vagus Nerve is out of
whack. In this chapter, you will learn how to stimulate the Vagus nerve and
how it works.

First, for the Vagus Nerve to work properly, you need to conserve energy by
being aware of your body's needs. If you cannot maintain a tempo where
you can focus on what is important in life, your mind will wander around
with little concentration as everything seems to be a distraction.

Second, you need to remember that you're not just thinking about one thing
when you are in the moment. Your thoughts are bouncing all over the place,
and sometimes that can be frustrating because you feel like your thoughts
overstep boundaries. The good news is there's a solution to this problem.

Third, develop a daily routine involving physical activity and eating

balanced meals. You can also try taking supplements such as turmeric or
goji berries that help with cognitive functions such as memory and
concentration. The Vagus nerve is important because it gives us a sense of
well-being and happiness throughout our lives, but it works in shifts
depending on the circumstances or moods of the people around us.
Chapter 5. VAGUS NERVE
 Autonomic nervous system.
The autonomic nervous system is a division of your body that controls and
regulates involuntary actions. These actions function without any conscious
control from the brain. For example, one involuntary action controlled by
the autonomic nervous system is breathing. Breathing happens
automatically and involuntarily. Another involuntary action is sweating,
which controls body temperature.

The autonomic nervous system is viewed as having two divisions: the

sympathetic nervous system and the parasympathetic nervous system. The
sympathetic and parasympathetic divisions of your autonomic nervous
system work together to ensure you are balanced within your body. For
example, one set of nerves will make it, so you are hungry; another set will
let you know you are full. This is why sometimes hunger can be
overwhelming and hard to ignore, even when your stomach feels like it's
about to burst or you feel nauseous from over-eating. This results from the
sympathetic nervous system working against the parasympathetic system.

The parasympathetic nervous system has three main parts: the cranial
nerves, spinal nerves, and sacral nerves. These parts work together to
regulate involuntary actions within your body.

The cranial nerves are twelve in number, extending from different parts of
your brain to different parts of your body. The head is controlled by the fifth
cranial nerve, while the face and hands are controlled by the seventh,
eighth, and tenth cranial nerves. The neck and shoulders are also controlled
by separate portions of the tenth cranial nerve.

The spinal portion of your parasympathetic nervous system comprises 12

sympathetic nerves. These sympathetic nerves bring out some of your
involuntary actions, such as breathing.

There are three sections to a sympathetic nerve: dura mater (stored in your
skull), medulla oblongata (your spinal cord), and visceral nervous system
(located in your abdomen). The visceral nervous system is the most
important part of your parasympathetic nervous system. The visceral
nervous system comprises your stomach, intestines, pancreas, kidneys, and
other organs in the digestive tract. The vagus nerve is an example of a
sympathetic nerve within this visceral nervous system.

The vagus nerve is your tenth

cranial nerve, but it also serves
as a part of your
parasympathetic nervous
system. It controls functions
such as chewing and
swallowing food, organ activity
within your digestive tract, and
heart rate. The word "vagus"
references a wandering action
that this nerve takes after
leaving the brain. It travels
down your neck and into your
chest. The vagus nerve goes to
your liver, pancreas, stomach,
spleen, and intestines. Getting to certain organs within the digestive tract,
such as the stomach or intestines, takes a rather winding pathway that
takes it back out of the body via an opening in the diaphragm.

The sympathetic nervous system comprises 12 nerves that extend from

different parts of your brain to different parts of your body. The fifth cranial
nerve extends from part of your brain called the hypothalamus to receptors
in your eye. The sixth cranial nerve extends from the hypothalamus to
receptors in your skin and face. The seventh cranial nerve extends from the
hypothalamus to receptors in your muscles and face. The eighth cranial
nerve extends from the hypothalamus to receptors in your lungs and vocal
cords. The ninth cranial nerve extends from the hypothalamus to receptors
in your heart, stomach, and intestines. The tenth cranial nerve extends from
the hypothalamus to receptors in your neck, throat, and chest.

The vagus nerve is a unique structure containing sympathetic and

parasympathetic nerves. It is an important part of the parasympathetic
nervous system, but at the same time, it contains sympathetic or emergency
nerves that allow you to respond to intense situations.

The emergency or sympathetic component of your vagus nerve is called the

X-delta component of your vagus nerve. X-delta refers to the receptor's
name, where impulses are transmitted into a sympathetic pathway within
your body. The X-delta receptors are located in all areas of your body but
are most numerous in the lungs and carotid sinus. These receptors are
responsible for functions such as stimulating glands and muscles within
your body during stressful moments. The most famous of these functions is
sweating. The sweating response is generated from the over-accelerated
heart rate and breathing to prepare your body for intense physical exertion.
The X-delta receptors are responsible for causing you to sweat as a result of
anxiety or stress.

X-delta receptor

In addition to the
sympathetic component,
your vagus nerve also
contains parasympathetic
nerves called the L1
segment of your vagus
nerve. These
parasympathetic nerves
are responsible for
regulating functions such
as heart rate, piloerection
(body hair that stands up
due to warming), and
sweating. They also control
gastrointestinal peristalsis, the contraction of muscles in your digestive
tract.

X-delta receptors and L1 nerve fibers

The X-delta component of your vagus nerve and the L1 component of your
vagus nerve are opposite in their actions. However, they both control a very
similar response. The X-delta component is responsible for turning on your
sympathetic nervous system, which increases your heart rate and causes
sweating when you are anxious or stressed. On the other hand, the L1
component turns on your parasympathetic nervous system, which lowers
your heart rate and allows you to relax when you are anxious or stressed.

Why is this important? Well, it can tell us a lot about how functions like
stress and anxiety work in our bodies. The X-delta component causes you to
sweat, get a racing heart, and breathe faster because it prepares your body
for fight or flight. Your brain prepares you to defend yourself physically or
run away from danger. The parasympathetic nervous system is responsible
for relaxing your muscles and slowing down your breathing so you can be
calm in the face of danger. If these responses did not occur when you were
in danger, you would likely die. These bodily functions must occur without
our awareness of them because if we considered every little action our
bodies took during stressful times, we would be paralyzed by fear.

The X-delta component of your vagus nerve is responsible for these

emergency responses by turning on your sympathetic nervous system.
Without the X-delta component, you would have no way of dealing with
intense physical situations that occur in life, such as running from a violent
person or fighting off an attacker. If the X-delta receptors were not
activated, you would be unable to sweat, you would have a very hard time
breathing, and you would be unable to unclench your fists when angry.

When this response occurs without our awareness of it due to it being

hardwired into our brains by evolution, it is called subliminal. What
constitutes subliminal information to us is information that can be perceived
by our subconscious or unconscious minds without our awareness. This
includes any stimulus below our level of consciousness and requires a
conscious response. This might include a smell, a sound, a sight, or even the
feel of something around you. Subliminal messages are often hard to detect
because they trigger the same response in our conscious and subconscious
minds, so we may not be aware that we are responding to one when we
would otherwise experience no response. Many scientific studies have
examined how subliminal messages work on us, and there is no doubt that
many of them cause a physiological response when exposed to them.
So how do subliminal messages get into our brains and cause such a
physiological response without awareness?

Humans can take in information even if it is below our level of

consciousness. For example, you can see something outside on the sidewalk
or hear a noise or smell something that causes you to startle, but you will
likely not think about it consciously. Many aspects of human behavior are
thought to be hardwired into our brains due to this behavior becoming
prevalent during our evolution. Therefore, subliminal messages are believed
to be transferred onto the X-delta receptors and L1 nerve fibers by being
stored in our unconscious minds. The X-delta receptors and L1 nerve fibers
are responsible for reusing those messages and making them available to
read.

Subliminal messages can come from many sources. The above explanation
exemplifies how subliminal messages are delivered because it involves the
X-delta receptors and L1 nerve fibers. The eye, for example, is another
source of subliminal messages because we see things we don't realize.
Subliminal advertisements on television or in magazines are also potential
sources. They are delivered by the skin, consciousness, and other receptors
via subliminal sentences that cause the same physiological response as seen
with the X-delta receptor mechanisms described earlier.

When you see something, hear, smell, or feel something that causes a
response in your body, it is called subliminal information. Subliminal
information has to do with stimuli you can perceive but don't necessarily
know. For example, take the following picture:

This picture probably caused a slight feeling of sadness in you because it

contains human suffering and death. While this picture did not cause
conscious thought to occur in your brain while looking at it, your
unconscious mind perceived the image. It processed this image and the
emotions associated with it and caused an unconscious feeling of sadness in
your body.

The brain-body barrier.

There is a boundary that keeps your brain from getting involved with the
bodily processes of your body. It's called the vagus nerve, and it's named for
its function: to control involuntary muscles and regulate the speed at which
they contract. The vagus nerve connects the brain to the heart, lungs, and
stomach. All these organs directly connect to your brain, so rather than
thinking about your digestive system during a test, clarify which muscle you
are testing by pointing to it. If you think too much about your heart or
lungs, you will get a response from them as a reflex.

This barrier is quite effective as other body areas are much easier to access
for our minds. It works when we cut ourselves and bleed. Our brains
recognize that our bodies need more oxygenated blood to help fight off
pathogens and heal wounds, so we consciously will ourselves to hold our
breath and tighten the muscles around our lungs. This causes a restriction
in airflow as the diaphragm is pulled down, which restricts air intake. The
vagus nerve plays a role in this process by subconsciously sending signals
from the brain to constrict these muscles, even before we realize what's
happening. If you're driving from point A to point B and you're cut off by a
driver zipping in front of you, or your boss tells you he's giving your project
to someone else, you're honking the horn. You're rarely annoyed by drivers
who are going slow and in a line in front of your car.

Sex differences in heart rate variability. Another example is when we get

upset with our significant other and yell at them. If we look at our heart
rate, it increases and becomes more variable, which is a natural stress
response. This is because we need more oxygenated blood for our muscles
in a fight-or-flight situation. Think about the last time you were chased by a
bear or knew you had to get across campus during an earthquake, and your
heart rate was elevated -- it's because your brain was telling your body to
prepare itself for action quickly to stay alive. Panic attacks.

The vagus nerve is a huge part of the brain-body barrier, but it's not the
only one. The brain also has to be able to communicate with your muscles
so that you can move and act efficiently. The problem with this
communication is that as we age, it doesn't work as well as it used to. This
is because our bodies and brains are changing, so our nervous systems have
had to adapt for us to remain effective at our jobs, manage stress, and stay
healthy. Think about this scenario: You're trying out for a new band in
college and have a good chance of getting in. You're elated, but then you
get to the tryouts and realize everyone else has had training. It's
competitive, so you're stressing about whether you'll get in. The vagus
nerve helps with this process by adjusting the muscles in your mouth to
change how the brain perceives certain sounds. If someone asks you how
your day is going, you will feel compelled to spit out a response without
thinking about it. You can add a "fine" or "good" or whatever you want to
reinforce your message, but the response will come out automatically.

If it weren't for this process, you would want to go home where you feel safe
and warm after stressing out because you said something embarrassing in
front of everyone. This is why we're compelled to respond to anything that's
put in front of us -- it's our brains helping us move on from a stressful
situation.

The brain-body barrier works by inhibiting signals and sending messages

that help us perform tasks. It's difficult to do anything if you don't get a
response from your body, so this is how the brain-body barrier keeps us safe
from harm. But now we are growing older and natural changes are
happening to our nervous system that causes problems such as clogged
arteries, strokes, and dementia. The brain-body barrier is breaking down,
which means that some of the signals it uses aren't working as efficiently as
they used to -- remember when you get angry every time your partner walks
by you? If a friend does something that upsets you, it doesn't take much for
your stress levels to rise because your brain knows something negative is
about to happen. It's a good thing, but when the cause is trivial and nothing
bad happens, it can be very frustrating.

We need to take from this that natural processes are happening in your
body and mind that you can't control. Some of them can help you stay
healthy, but others can keep you from functioning at your best -- especially
if you're terrified of being judged. This means that when you get nervous
during a presentation or test, it's not because your body isn't working
properly; your brain thinks something bad is about to happen and wants to
prepare for it.

It's easy to blame the brain-body barrier for our problems, but not
everything it does is bad. If you think about the last time your body was
stressed and went to a social event, you probably ended up enjoying
yourself. As you age, your brain is more active because it's adapting to
allow you to do the activities you enjoy (which is why people over 60 are so
happy with their lives). The vagus nerve correlates with this process, and
when your brain can communicate better with your muscles, this also allows
for more positive emotions like physical affection. In other words, we need
to embrace many benefits of our brains' natural processes, especially if
we're looking for a way to survive in today's society.

The brain-body barrier gets a bad reputation, and many misconceptions

about what it does. We're going to go over some of the negative effects so
you can understand how the brain-body barrier can make your life harder
by not allowing signals. The brain-body barrier traps air in your arteries,
which causes clogged arteries.

This happens when there's an issue with the signaling process between your
diaphragm and your kidneys -- the kidneys have to filter blood constantly
and send messages from the brain to let them know what's happening with
our bodies. When the brain doesn't communicate effectively, your kidneys
will allow more air into your bloodstream. This means your blood pressure
won't be as high, and you won't have to worry about a stroke or heart
attack. This is a good thing because you probably have high blood pressure
when you sit down to do work (you're probably not moving around much
when you're in class), but this can cause issues if you get angry or stressed
out -- it can prevent the body from being able to exercise properly.

Cognitive decline can also occur because of an airlock in your arteries.

Often we get frustrated when we don't remember things the way other
people do. But when your brain
has to filter out too many things
from the environment, it has a
hard time getting through all this
information, and you'll find
yourself forgetting things that you
used to be able to do easily.
Remember when you couldn't
figure out how to turn your
computer on? That's because
there's an issue with your brain trying to communicate with your body
about something important. What should have been easy is now a bit of a
hassle because it's taking longer for your brain and muscles to
communicate well.

How you're feeling is a result of these signals. Many people think that they
can use willpower to control how they feel, and it's worked in other areas of
their life, but it doesn't work here. The truth is that your body is doing what
it was meant to do -- that's why some people can have the energy to climb
mountains and jog for hours, while others can't even leave the house
without getting tired. Your body is trying to communicate with your brain
about something important, but your brain doesn't get the message because
it's too busy thinking about things from the past -- like whether you'll be
accepted into a new school.

The neurology of social engagement

The vagus nerve is the tenth cranial nerve that travels inside the head and
controls functions like heart rate, respiration, blood pressure, and digestion.
It also plays a key role in initiating social engagement because its fibers
pass through the brain stem. The vagus nerve detects changes in our
surroundings, such as sound, touch, taste, and smell. This information then
gets processed by other nerves, such as the parasympathetic nervous
system, which innervates most of our organs, including the heart and lungs,
resulting in increased heart rate and respiration.

The Vagus nerve offers a way to manipulate the parasympathetic nervous

system through Vagus Nerve Stimulation (VNS). VNS is a treatment option
for people with epilepsy or depression. It works by sending electrical pulses
through the vagus nerve to stimulate it, and as a result, it positively impacts
mood, alertness, and overall behavior. The theory behind VNS is that vagus
nerve stimulation modulates activity in brain regions linked to regulating
mood and behavior, such as the amygdala and prefrontal cortex.

In addition to managing stress, the vagus nerve also plays a key role in
anxiety. Increased vagus nerve activity can lead to anxiety due to its
connection to the amygdala and prefrontal cortex. Two parts of the brain
deal with negative emotions, including fear and stress. Therefore, people
who are prone to anxiety are less likely to respond positively to treatments
like VNS because it is likely that VNS will increase their stress.

The role of the amygdala and prefrontal cortex in social engagement is not
yet clear, but research has found that psychological treatment like VNS is
successful in treating social anxiety when it is used along with behavioral
therapy; however, improvements are only slight when used alone.

Social engagement-related disorders like social anxiety and autism are

relatively recent, but they occur at a higher rate than expected, and their
occurrence is rising. Research is continuously being done to understand
their relationship with the brain, mostly focusing on the amygdala and
prefrontal cortex. Current treatments for social anxiety are somewhat
effective but insufficient in treating the disorder. There is a need for a
better understanding of how these two parts of the brain interact with each
other because it will aid in developing better treatments for people
suffering from social anxiety.

The Vagus nerve is partly responsible for the fight and flight instinct; this is
an instinctive reaction to stressful situations. A trigger for this reaction may
be the smell of a stranger nearby or perceived danger, which leads to
activation of the sympathetic system. This results in releasing chemicals like
adrenaline, noradrenaline, and cortisol. These chemicals prepare the body
to defend itself from danger. A consequence can be an increased heart rate,
reduced blood flow to the digestive organs, and elevated blood pressure
before running away from danger. The fight and flight response results from
a strong autonomic nervous system response.

This response is important when it comes to social engagement because it is

necessary to be able to interact with other people. The more we engage
with people, the more the brain can develop communication skills. For
example, a child can learn how to put objects into a box through
observation, but they will never know how to use their imaginations and
creativity if they do not engage in social interaction. They will never be able
to be creative because they do not understand that there are different kinds
of objects. This lack of understanding means that children's lack of
cognitive development can lead to behavioral problems such as anxiety and
an autism spectrum disorder.
Keeping participation in society a priority for individuals who struggle with
neurobiological and neurodevelopmental disorders is important. The
importance of socialization has been proven through research. One study
showed the effect of group-based interventions over individual ones in
treating autism spectrum disorder. While some people may be wary of
putting their children in social settings, they should be encouraged to do so
and allowed to explore within their comfort levels. A child will not learn to
engage socially unless they are allowed to engage socially, and if they are
not given the opportunity, this area can be problematic later in life.
Therefore, social engagement is key to a successful and healthy functioning
brain.

Vagus nerve stimulation is useful for treating epilepsy and depression, but
many people have concerns about its use, in addition to the fact that it is
not approved for children. This neurostimulation has been valued as an
effective treatment for years. Still, its acceptance has been limited by
ethical debates such as the issue of personhood, questions of consent, and
issues with some people's fear of being "zapped." The debate over consent
points to the importance of obtaining patient consent and the ability to
empathize with those who hesitate. These issues have caused some people
to question whether the benefit of VNS outweighs any potential risk.
Though the procedure has been in use for over a decade, little research has
been conducted to study the long-term consequences of VNS. It may not be
harmful, but it is also possible that VNS may cause psychological or
physical damage through long-term use. Even though the procedure does
not cause any physical damage, there are still concerns about memory loss
and cognitive decline. How much brain plasticity exists for those who have
received VNS? Can patients retain self-control under such stimulation?
These concerns add to the controversy surrounding SNS and its effects on
cognition, an area of research that doctors and scientists want to
understand better.

VNS causes daily costs ranging from $1,000 to $1,500 per month. The costs
are higher than the benefits of the procedure because it is still unknown
whether or not it will improve a patient's quality of life. Since the FDA does
not approve VNS for treating autism spectrum disorder, many insurance
companies do not cover VNS expenses. Parents may pay for it out of pocket;
applying for grants can help lower expenses for some families. The expense
requires those who are considering VNS to consider the risks and benefits
carefully before deciding on whether or not to have it performed.

The word “vigilance” comes from Latin, which means to stay awake.
Vigilance is an important part of the fight or flight response and is, in most
cases, helpful but can sometimes be problematic. It is useful in the case of
protecting ourselves from danger, but it can also be a challenge when we
are anxious and hypervigilant. When anxious or hypervigilant, we are
constantly on alert; our minds are always running, even when nothing is
wrong. Being vigilant sometimes makes us more prone to remembering
things incorrectly.

The fear of missing a critical moment or being distracted by something

irrelevant can disrupt daily life. In many instances, being overly vigilant can
make a person feel more anxious and more likely to have an immediate
negative response to stimuli.

Neuroplasticity is the ability of the brain to rewire itself through practice

and training. A physically capable person can learn how to perform new
tasks, such as running a marathon or playing an instrument on their own,
but it takes additional years of experience to do this successfully. The brain
is similar in that it takes training and practice for the individual brain to
reach its potential. These training exercises help a person improve what
they do and improve their skills. Through proper training, individuals can
develop cognitive flexibility, which is the ability to shift attention.

An example of this can be seen in working memory. Working memory allows

for the storage and manipulation of information that is being processed at
the moment. It is crucial for problem-solving and other executive functions
such as planning and inhibition, which are used in deciding where to focus
attention. Training with spatial cues improves working memory because it
allows a person to pick up on patterns that they normally would not be able
to see. This is because people who lack spatial abilities are less likely to
notice patterns around them or even see them without any kind of cue.
People who struggle with this can be trained to pay attention to the space
around them.
The brain constantly learns and can improve, if necessary, through practice
and time. In the case of people who have had head injuries or strokes, their
brains may have been damaged to varying degrees. When the brain is
injured in this way, it needs more time to recover and heal than expected.
Neuroplasticity allows for recovery by enabling the brain to move misplaced
neurons or rewire unused connections between neurons. The plasticity of
the brain allows individuals with mild memory problems to improve their
memory skills and prevents further damaging effects from occurring due to
aging or disease.

The twelve cranial nerves

The twelve cranial nerves that run through the brain stem are attached to
the vagus nerve, a bundle of nerve fibers running down the neck. This nerve
plays a key role in our autonomic nervous system, which regulates body
temperature, heart rate, and lung function. The vagus nerve is one of two
cranial nerves related to speech (the other being the Inferior Ganglion),
responsible for conveying sensory messages from the larynx and pharynx.
Therefore, tumors can
originate from or spread along
this pathway.

Different cancers can damage

cranial nerves due to invasion
into or compression of the
nerves. The cranial nerves
that are most often affected
are the vagus nerve and the
trigeminal nerve.

There are 12 pairs of cranial

nerves in humans. These
nerves originate in the brain
stem and exit through separate openings in the skull called foramina
(singular: foramen). The cranial nerves control body functions that include
sight, hearing, taste, smell, facial movements, balance, and other sensory
stimuli related to vision and hearing, as well as motor functions such as
speech, mastication (or chewing), and swallowing.

The vagus or tenth cranial nerve originates from the brain stem's medulla
oblongata at the skull's base. It runs down through the neck and enters the
thorax, where it splits to supply different areas of the body. The vagus nerve
is important in controlling heart rate, lung, and digestive system functions.
Damage to the vagus nerve can lead to a dropping heart rate, resulting in
light-headedness, fainting, and dizziness. Damage to this nerve can also
cause a drop in blood pressure, which may lead to tachycardia (rapid
heartbeat) and an irregular heartbeat that can lead to syncope (fainting).

The vagus nerve helps to regulate the digestive system. It carries signals
from the digestive tract to the brain, allowing a person to monitor body
processes and digest food. The vagus nerve is also used in speech and is
responsible for communicating feelings such as crying, laughing, and
tasting sensations.

Therefore, the twelve cranial nerves include:

1. Facial

This nerve consists of the facial nerve (CN VII) and the inferior alveolar
nerve (CN V3). The facial nerve transmits information from the face, eyes,
forehead, and scalp to the brain. The inferior alveolar nerve transmits
information from the mandible and maxilla to the brain. It is essential since
the nerve supplies the facial muscles and is linked to the motor mechanisms
of chewing, speaking, swallowing, and blinking.

The facial nerve may be damaged when underlying tumors spread and press
on it. This can lead to drooping of the eyelids, perioral numbness or
weakness, hearing loss (if connected to the ear), or facial pain. Moreover, a
tumor that presses on the facial nerve may cause a loss of sensation in the
face called hemifacial anhidrosis. Tumors or infections may damage the
inferior alveolar nerve. Infections such as tooth abscesses, gum disease, and
osteomyelitis can damage this nerve and subsequent tooth pain or difficulty
chewing.

2. Optic
This nerve consists of the optic nerve (CN II) and the ophthalmic branch of
V1 (a branch of the trigeminal nerve). It transmits information from the
retina to the brain. Therefore, damage to this nerve can lead to visual
impairment due to blindness, visual field loss, or double vision. In addition,
damage to the optic nerve can cause involuntary actions of the eyes without
conscious control, such as blinking, squinting, and eye movements.
Therefore, this nerve is essential since it allows us to see.

The optic nerve can be damaged by tumors that spread and compress the
nerve or by infections and inflammation. Moreover, it may be damaged
when tumors develop in the eye and spread along the optic pathway.

3. Olfactory

This nerve consists of the olfactory nerve (CN I) and the vomeronasal or
Jacobson's nerve (CN IX). It transmits information from the olfactory bulb in
the brain to the nose. A tumor that presses on this nerve may cause a loss of
sensation in one or both nostrils, and it may also lead to changes in smell
due to damage to olfaction areas on either side of the nose. In addition, it
can spread to other parts of the body.

The olfactory nerve may be damaged by tumors that press on the nerve or
by infections. Tumors may also spread to this nerve in people with certain
autoimmune disorders and certain types of cancer.

4. Oculomotor

This nerve consists of the oculomotor nerve (CN III) and the trochlear nerve
(CN IV). It transmits information from the brain to muscles responsible for
eye movements, such as adduction, abduction, elevation/depression, and
circumduction. It also sends information on pupil diameter to the brain.
Therefore, damage to this nerve can lead to double vision or blindness.
Moreover, it can spread to other parts of the body.

The oculomotor nerve may be damaged by tumors that compress or press

on it or by infections and inflammation. In addition, tumors with
compressive or infiltrative growth patterns may damage this nerve as they
grow outward into surrounding tissues or toward deeper structures.
Moreover, it may be damaged when tumors develop in the eye and spread
along the optic pathway. The trochlear nerve may also be damaged by
tumors such as acoustic neuromas and meningiomas that grow into or
adjacent to the nerve.

5. Trigeminal

This nerve consists of the ophthalmic (CN V1), maxillary (CN V2), and
mandibular (CN V3) divisions. It transmits information from the brain to
muscles responsible for chewing, biting, swallowing, and other motor
functions of the mouth. Therefore, damage to this nerve can lead to facial
weakness or numbness on one side of the face (hemifacial atrophy).
Moreover, it can spread to other parts of the body.

The trigeminal nerve may be damaged by tumors that press on this nerve or
by trauma (such as a blow to the head). Moreover, it may be damaged when
tumors develop in areas such as the base of the skull or the brain and
spread along the trigeminal pathway.

6. Abducens

This nerve consists of CN VI and V2 (a branch of CN V1). It transmits

information from the brain to muscles responsible for eye movements, such
as abduction, adduction, and upward gaze. Therefore, damage to this nerve
can lead to double vision or blindness. Moreover, it can spread to other
parts of the body.

The abducent nerve may be damaged by tumors that press on this nerve or
by trauma (such as a blow to the head). Moreover, it may be damaged when
tumors develop in areas such as the base of the skull or the brain and
spread along the route of CN VI.

7. Trochlear

This nerve consists of the trochlear nerve (CN IV) and the superior oblique
muscle (CN III). It transmits information from the brain to muscles
responsible for eye movements, such as elevation, depression, and
abduction. Therefore, damage to this nerve can lead to double vision or
blindness. Moreover, it can spread to other parts of the body.

The trochlear nerve may be damaged by tumors that press on it or by

trauma such as a blow to the head. Moreover, it may be damaged by tumors
developing in areas such as the base of the skull or the brain and spreading
along CN IV.

8. Interosseous

This nerve consists of CN XI and XII. It transmits information from the brain
to muscles responsible for finger movements, such as abduction and
adduction. Therefore, damage to this nerve can lead to the inability to move
fingers in certain ways or loss of sensation in them. Moreover, it can spread
to other parts of the body.

The interosseous nerve may be damaged by tumors that press on it or by

trauma (such as a blow to the head). Moreover, it may be damaged when
tumors develop in areas such as the base of the skull or the brain and
spread along CN XI and XII.

9. Deep peroneal (or tibial)

This nerve consists of the deep peroneal nerves and the extensor digitorum
longus muscle. It transmits information from the brain to muscles
responsible for foot movements, such as dorsiflexion, plantar flexion, and
eversion. Therefore, damage to this nerve can lead to various problems with
movement in the foot and ankle due to permanent weakness or paralysis on
one side of the body or foot. Moreover, it can spread to other parts of the
body.

The deep peroneal nerve may be damaged by tumors that press on it or by

trauma (such as a blow to the head). Moreover, it may be damaged when
tumors develop in areas such as the base of the skull or the brain and
spread along the deep peroneal nerve.

10 . Vagus

This nerve consists of the vagus nerve (CN X) and various visceral nerves. It
transmits information from the brain to various body parts, such as the
pharynx, heart, lungs, and stomach. Therefore, damage to this nerve can
lead to hoarseness or problems swallowing (due to damage to the pharynx),
heart problems that may lead to heart failure or irregular heartbeat(due to
damage to the heart), difficulty breathing (due to damage to the lungs), and
upper abdominal pain (due to damage to the stomach). Moreover, it can
spread to other parts of the body.

The vagus may be damaged by inflammation or tumors that involve this

nerve or by trauma (such as a blow or a car accident). Moreover, it may be
damaged when tumors develop in areas such as the base of the skull or the
brain and spread along the vagus nerve.

11. Hypoglossal

This nerve consists of the hypoglossal nerve (CN XII) and the muscles of the
tongue and palate. It transmits information from the brain to muscles
responsible for tongue movements, such as protrusion, retraction, and
elevation/depression. Therefore, damage to this nerve can lead to the
inability to move the tongue in certain ways or loss of sensation. Moreover,
it can spread to other parts of the body.

The hypoglossal nerve may be damaged by inflammation or tumors that

involve this nerve or by trauma (such as a blow or a car accident).
Moreover, it may be damaged when tumors develop in areas such as the
base of the skull or the brain and spread along CN XII.

12. Visceral (responsible for vomiting)

This nerve consists of CN IX, X, and XI. It transmits information from the
brain to muscles responsible for vomiting (similarly to the role of the vagus
nerve). Therefore, damage to this nerve can lead to vomiting due to damage
to the brain or stomach. Moreover, it can spread to other parts of the body.

The visceral nerve may be damaged by inflammation (such as gastritis)

caused by tumors that press on it or by trauma (such as a blow or a car
accident). Moreover, tumors may develop in areas such as the base of the
skull or the brain and spread along
various parts of these nerves.

What is the vagus nerve?

In the simplest terms, the vagus nerve is
a long nerve that runs from your brain
stem to your abdomen. It's part of the
body's parasympathetic nervous system and helps you relax after a stressful
day.

The best way for most people to release tension in their bodies is by lying
down with their head on a pillow, using deep-breathing exercises, or even
just walking for 20 minutes. In other words, you rely on your vagus nerve to
calm down after exercising, or stress levels are high.

The parasympathetic nerve helps your body rest and recover from a
stressful day, and the vagus nerve is where you relax and restore yourself
after you've had a stressful day.

One of the main nerves in your body runs down from your brain stem to
your abdomen. It's called the vagus nerve because it originates in the brain
stem and moves through the neck and down to the heart and the abdomen.
It has two parts to this process: one part to help control swallowing and the
other part that helps govern digestion. It also sends signals for your heart
rate to slow down and for the sphincter at the bottom of your esophagus to
relax (allowing food to back into your mouth).

The vagus nerve is responsible for triggering your relaxation response. It

helps you breathe deeply, which leads to a calm state of mind. It slows down
the heart rate and lowers stress hormones in the body. Deep breathing
works via the vagus nerve. So if you're trying to calm down, speak slowly
and breathe deeply; those are simple exercises that trigger it.

The vagus nerve is also responsible for helping you release stress. It slows
down the heart rate, relaxes the muscles around your esophagus and
stomach, lowers blood pressure, and improves glucose levels in the
bloodstream.

Many people are unaware of the vagus nerve's role in their lives. They
haven't discovered that they could relax and relieve tension by using simple
relaxation techniques such as deep breathing or sitting quietly. So we're
going to talk about the vagus nerve now.

There are two types of the vagus nerve: the afferent and efferent vagus
nerves.
The afferent vagus nerve sends signals to the brain that allow a person to
experience feelings of satiation after eating, leading to decreased appetite.
It is activated by the hormone ghrelin, which works on the hypothalamus.
The efferent vagus nerve helps control food movement through the
digestive tract and also helps control heartbeat by slowing it down. The
efferent vagus nerve sends signals from the gastrointestinal tract to the
Vagus Nerve Bud in the brainstem, which passes information onto different
areas of your brain, including those related to appetite control and
digestion. It's also responsible for lowering your heart rate. The vagus nerve
is sometimes called the "wandering nerve" because it moves through so
many parts of the body.

The cranial component, or "cranial nerves," of the vagus nerve includes the
Facial Nerve: This nerve controls voluntary movements of muscle related to
facial expression, including smiling and frowning.

Vagus Nerve: Consists of two parts—one that provides sensation to the neck
and throat area and one that deals with the movement of muscles related to
swallowing food and liquids. Both parts are important for normal
functioning in these areas.

Vestibulocochlear Nerve: Provides functions related to hearing and

equilibrium (balance).

Glossopharyngeal Nerve: Provides control of motor function for muscles

related to swallowing.

Brain Stem: Provides important functions related to the brain, including

auditory and visual function and consciousness. Approximately 1 million
fibers of the vagus nerve innervate the gastrointestinal tract. They are
excitatory, mainly affecting secretion, motility, and sensation. Vagal
innervation of the gut is via both sympathetic (thoracolumbar) nerves,
activating effects on muscle and secretory cells in the gut, and
parasympathetic (cranial) nerves, which mostly have inhibitory effects. In
addition, two main branches of the vagus nerve innervate different parts of
the gut. The larger of these two branches, the deep vagus nerve (VDR), runs
along the bottom of the esophagus and then splits into a superficial vagus
nerve and a long thoracic vagus nerve. These nerves are located close to
each other. Your face is covered with a massive network of nerves called
cranial nerves. This network gives you your eyes, ears, mouth, and nose, but
it also helps control your digestive system by sending signals from your
stomach to your brainstem and from there to other regions of your body.

Characteristics of vagus nerve include:

a. Efferent vagus nerve is a long, primary neuron originating in the CNS

and terminating at muscle or glands.

b. Efferent vagus reaches most organs.

c. Efferent vagus has both motor and sensory functions (gustatory, auditory,
cardiac, and tubular functions).

d. Afferent enters through the dorsal root ganglion (trigeminal) and leaves
the spinal cord via the dorsal root.

e. Afferent vagus has sensory modality only (smell).

f. The afferent/efferent segregation is not sharp – there are motor points on

both sides of the trachea and sensory points on both sides of the stomach.

g. Vagal fibers join the cranium and sacral plexus at the level of the
medulla.

h. The visceral motor nuclei are located in the medulla, PNS, and spinal
cord (mainly at sacral levels).

The Vagus nerve is a mixed nerve which means that it has both sensory and
motor branches. Motor branches of the vagus nerve (3–6) innervate muscles
of the pharynx, larynx, trachea, and esophagus so they can control their
movements – except epiglottis, which is innervated by the superior
laryngeal branch of the hypoglossal nerve. Sensory branches of the vagus
nerve (7–9) provide taste sensation on the epiglottis and pharynx, general
sensation to the larynx, and sensory input from the esophagus.

The vagal nerve has two major branches: the short cervical ventral rami and
the long thoracic ventral rami, which innervate the viscera of the thorax,
abdomen, and pelvis.
Vagus nerve innervation of serosal surfaces is in dermatomal order:
tracheobronchial tree (C3-4), bronchial tree (C4-5).

Vagus nerve projections to abdominal viscera are as follows: coronary

arteries, splanchnic nerves (S2-S4), mesenteric plexus, vas deferens, and
the testis.

The vagus nerve is involved in eating behavior by triggering the satiety

center in the hypothalamus to signal the cerebral cortex of your brain. If a
person were to eat all they wanted but they remained hungry and overate,
they would most likely eat too much in one sitting (this is called binge
eating). If a person were to eat when they are full, people call this
"satiated": this is the behavior of people with anorexia nervosa or bulimia
nervosa.

The vagus nerve is also involved in controlling heart rate and blood
pressure. The vagus nerve is a bridge between the gastrointestinal tract and
the brainstem and a conduit for food to reach other parts of your body.
Research has shown that patients who have undergone vagotomy have high
blood pressure, delayed gastric emptying, decreased heart rate, and
increased blood cholesterol levels. The vagus nerve is one of the most
fundamental pathways for afferent information about our bodies' internal
state and relationship to the external environment. When we are hungry,
signals from our stomach travel to our brain via this pathway which initiates
eating behavior. When we are physically active and begin to get tired,
signals from the periphery travel to our brain via the vagus nerve. This
results in the initiation of restful behavior. We can control this pathway via
a simple hack: research has shown that chewing gum can improve your
homework performance and athletic performance (e.g., increased stride
length during running). Chewing gum increases saliva production, which
signals your body that it is not in danger of starvation.

The Vagus nerve is responsible for the primary motor function of cranial
nerves IX, X, XI, and XII and a taste sensation in the posterior one-third of
the tongue.

The Vagus nerve innervates many organs, including the heart (pulse and
contractility), lungs, bronchi, thymus, spleen, pancreas, liver, and stomach.
The Vagus nerve is also connected with the chemoreceptors of the olfactory
pathway and mediates chemosensitivity to food-related stimuli. A Schiller–
Fuchs reflex can be elicited in monkeys and some humans by application of
a local anesthetic to the vagus nerve near the jugular foramen.

Historical recognition of vagus nerve.

The Vagus nerve (from Latin "vagus," meaning "wandering") is a paired
cranial nerve that lies in the neck. It carries sensory information to and
from the viscera or visceral organs, mainly carrying signals from the heart,
lungs, and major arteries. Leonardo da Vinci named the vagus nerve in
1493, which Harvey Cushing rediscovered in 1878.

On the surface of the neck, in the groove for the jugular vein, is a large
nerve, about as large as a crow quill. It arises from the medulla oblongata
and passes downward, lateralward, and backward, distributed to all neck
parts. It has been called the Nervus vagus (the wandering nerve). It is
distributed to all parts of the head, face, and neck except the lips, palate,
and glans penis. It supplies the muscles of the palate, the pharynx in
general, the larynx, and all muscles of the face except one – this is by a
branch from the cervical plexus. The vagus nerve is also responsible for
activating the vocal cords, therefore causing speech to be possible. It is also
the nerve that controls the external ear canal and foramen.

It innervates blood vessels, which are mostly in the abdomen and limbs.
Also, it has preganglionic parasympathetic fibers that synapse in the ganglia
of the superior cervical ganglion on its way out from the medulla.

The vagus nerve has three branches—the pharyngeal, superior laryngeal,

and recurrent laryngeal nerves. In addition, some anatomists name a fourth
branch—the sympathetic cervical nodes. The superior laryngeal nerve is the
main nerve to provide the larynx muscles with motor innervation. The
pharyngeal nerve supplies most of the plexus. It is also responsible for
laryngeal nerve palsy. It runs through the cervical ganglion and sends
projections to the superior cervical ganglion and the pre-tracheal muscles of
the neck and larynx.

The pharyngeal nerve probably arises from the recurrent laryngeal nerve or
the glossopharyngeal nerve. In humans, it passes downward and forward,
downward and backward, lateralward and lateralward, forward again, and
backward.

In mammals (including humans), both afferents from the vagus nerve and
efferents to its motor nuclei are known as axons. Efferent fibers originating
in the medulla and the brainstem carry signals to the lungs and heart. The
reflexes mediated by the vagus nerve are collectively known as the "vagal
reflexes" or "vagal responses." These reflexes are studied under the name of
"vagal regulation," focusing on gastrointestinal secretions, motility, and
respiratory function.

The vagus nerve produces parasympathetic effects on the heart and torso. It
increases heart rate, slows the heart's pace, and lowers blood pressure.

The vagus nerve also controls a reflex that causes the larynx muscles
(laryngeal reflex) contraction. When this occurs, it restricts airflow from the
lungs to ensure that only air from the mouth passes through the nose. This
reflex is mediated by a reflex arc formed in response to the stimulation of
sensory nerves located within the larynx—the glossopharyngeal nerve.

Historically, carotid sinus massage was used to stimulate the vagus nerve
and cause the larynx to become paralyzed. This action would temporarily
cause a person to stop breathing, causing the person to faint. Today, a
cardiac arrest is induced instead by stimulating the vagus nerve through an
electrode on the surface of the heart, a method known as cardioversion.

The vagus nerve plays an important role in the digestive system. It slows
down gastric motility and increases gastric emptying, allowing for more
effective digestion. This is accomplished by contracting the abdominal
muscles and releasing neurotransmitters (serotonin, acetylcholine, and
adenosine) that relax smooth muscle in the intestines, increasing motility. It
also controls the release of gastric juice during eating and food digestion by
slowing down peristalsis.

The vagus nerve is responsible for increased heart rate and blood pressure,
which are at their lowest when one is asleep or unconscious due to a drop in
sympathetic activity. This means that one's blood pressure and heart rate
will decrease greatly, even fainting in an unconscious state. The vagus
nerve is also responsible for opening the airway during a cough, allowing
air to pass through the trachea.

Many diseases and conditions can have a negative effect on the vagus
nerve, especially degenerative diseases of the brain such as Parkinson's
disease or amyotrophic lateral sclerosis (ALS). Vagus nerve involvement
with symptoms is commonly seen in chronic obstructive pulmonary diseases
(COPD) patients, such as bronchitis or emphysema. Vagus nerve
dysfunction can also be encountered in neurodegenerative diseases or
strokes. It can also be damaged by some forms of surgery, such as cervical
or thoracic spinal fusion.

Vagal nerve stimulation is a treatment for depression that has not

responded to other treatments. It was approved for use in the United States
by the Food and Drug Administration in October 2007 for patients who have
not responded to at least one antidepressant medication. Initial results
appear promising, but long-term outcome data are not available yet.

The vagus nerve plays an important role in controlling milk letdown during
breastfeeding. It stimulates milk ejection and contractions of the breast
(breastfeeding).

Some also believe the vagus nerve to be one of the weak links in the heart's
electrical conduction system, responsible for slowing down the heart rate.
More than 100 reported cases of cardiac arrest among medical students
during surgical procedures (cardiac arrest during surgery), which has been
attributed to decreases in vagal tone. The action may not be instantaneous
and will take time to produce full effects. Researchers attribute this effect to
the vagal inhibition of cardiac motility, which inhibits impulses from
reaching the atria and slowing down the heart rate.

The vagus nerve can be injured from medical procedures, particularly

during thoracic surgery. Commonly, the nerve is injured during thoracic
surgery or repairing of the spine. Vagus nerve injury is difficult to diagnose
as many signs, and symptoms are nonspecific as to origin.

Inhibition of one vagal effect (or its opposite) can cause bradycardia—a
slowed heart rate; however, overstimulation of the vagus nerve may lead to
tachycardia—a fast heart rate. In patients with vagal denervation syndrome
and certain other pathological conditions, bradycardia is the norm, and
tachycardia is seen only at times of great stress.

The vagus nerve, which contains parasympathetic fibers to the heart,

regulates both phases of the cardiac cycle, namely diastole (relaxation of
heart muscle) and systole (contraction of ventricular muscle). Thus, it is also
called "the heart nerve."

How to stimulate the vagus nerve.

Vagus Nerve: A nerve that is one of the nine pairs running to and from the
brain. It offers a branch to all body organs. The vagus nerve can be
stimulated through a position for meditation known as sama vritti (equal
breaths).

The main function of the vagus nerve is to control blood pressure by

relaxing the tone in large vessels and increasing the tone in small vessels.
Active also stimulates sluggish activities like heart rate, digestion, and
respiration.

Stimulating this nerve will have many positive effects on your health, such
as improved heart-rate variability and increased ability to respond more
appropriately during stress episodes or surges.

It will also calm your nervous system and reduce levels of C-reactive
protein, a biomarker for inflammation. Some research has indicated that
vagal stimulation can play a role in panic disorder, posttraumatic stress
disorder, obsessive-compulsive disorder, and other mental illnesses. In
addition, a study in male mice showed that stimulating the vagus nerve
decreased food intake, suppressed body fat storage, increased energy
expenditure, and abolished diet-induced obesity.

The Vagus nerve is one part of our parasympathetic nervous system which
is responsible for resting or healing the state of our bodies (digestion, sex,
etc.). The sympathetic nervous system is the other part of the
parasympathetic nervous system responsible for our fight-or-flight response.
So stimulating only the vagus nerve leaves us in this calm state where we
cannot produce any action to defend against stressful situations. We are
just sitting ducks waiting for something to come and kill us.
This position is more than just stimulating a nerve. It stimulates your
nervous system to naturally produce chemicals that will help heal and
balance out your whole body's nervous system instead of completely
ignoring it.

The vagus nerve runs from the base of your brain to your abdomen. It
temporarily puts your body into parasympathetic mode, which is
responsible for stimulating "rest and digest" responses. This will help to
switch you into a more relaxed state.

Vagus Nerve Stimulation: To stimulate the Vagus nerve to sit in any

comfortable position, take slow breaths through your nose and slowly
exhale through an open mouth after each inhalation (called Sama vritti).

This should be done for at least 15 minutes and up to an hour at a time. You
can also listen to a guided meditation (see below) while practicing this yoga
technique, making the process easier.

If you find it hard to focus on your breathing or are distracted, try to bring
your focus back to your breath. You can do this by counting each inhalation
and exhalation (one breath- one count or two -one or two- one).

Inhale 1, Exhale 2, and so on.

If you are using guided meditation, try to keep your mind focused on what
the voice is saying, but if it wanders again, return your focus back to the
voice.

Once complete, stretch out all your muscles, such as your arms and legs.
This will help return everything to normal once more after being relaxed.

Therefore, these tips can guide how to stimulate the vagus nerve:

a. Practice good posture (as a yoga beginner, learn about postures before
the practice)

b. Try to keep the spine straight, especially when seated and lying

c. Always try to breathe using your diaphragm (the floor of your chest
should move outward when you inhale and inward when you exhale). This
will activate the vagus nerve and help with proper oxygen intake/carbon
dioxide removal from your blood.
- And finally, to stimulate the vagus nerve correctly and safely, you need to
maintain a healthy diet and eating habits so that your body can easily
absorb all necessary nutrients and be maintained healthy at all times.
Taking in nutrients like minerals, vitamins, and antioxidants will keep your
body from becoming deficient.

Moreover, you should also be aware that there are two types of
neurotransmitters (neurotransmitters are chemicals that nerves release and
are used for sending signals between nerve cells).

The digested food travels to the stomach when you eat a meal, breaking it
down into glucose. The insulin hormone is released by the pancreas and
begins to convert glucose into the energy the brain needs to process short-
term memory. This is called insulin resistance (IR). This leads to type 2
diabetes. Insulin resistance occurs when there is an excess of insulin in your
bloodstream.

When you are IR, it is not just your brain that suffers. It also makes your
body vulnerable to becoming insulin resistant, in general. This means that
you will be more susceptible to type 2 diabetes and heart disease.

The same happens when your body becomes deficient in other minerals and
vitamins.

Therefore, when you eat a meal or snack, you should always choose foods
high in nutrients instead of foods high in calories without any nutritional
value.

Therefore, the best foods are:

i. Fruits and vegetables (organic)

ii. Whole grains such as brown rice and oatmeal (preferably organic)

iii. Nuts (preferably raw)

iv. Healthy fats such as fish and olive oil (organic)

v. Legumes

vi. Calcium-rich foods like milk and cheese.

d. If you are exercising, you should ensure calcium intake is at least 1200
mg.

e. Drinking any form of caffeine during the day will significantly reduce the
amount of sleep you get over the course of a 24-hour period, so try to limit
this as much as possible.

f. Try to eat foods with high water content, such as fruits and vegetables.

g. Sugary foods have been associated with many negative health effects,
including obesity, heart disease, and cancer. Avoid these like the plague.

h. Stressful events can impact levels of cortisol or stress hormones. High

levels of cortisol have been associated with high cholesterol and heart
disease. For example, if you are stressed, you may be eating more foods
that contain sugar to make up for the increased need for calories in your
body (to power through the day's stress). These sugary foods should be
consumed in moderation, and try to eat healthy fats whenever possible.

i. Exercise will help you lose weight and increase your energy level. This is
because, after a strenuous workout, your body burns glucose more rapidly,
which is a sign that insulin is working properly in your body.

j. Lastly, sleep is important to your overall health and should be taken

seriously. After all, as we mentioned earlier, sleep is one of the ways that
neurons in your brain communicate with each other.

Sleep can be very damaging to your health if you don't get enough of it
(which indicates that there are a lot of neurotransmitters working in your
brain that are not being utilized properly). Suppose you are constantly
stressed out and have a lack of sleep over the years. In that case, this can
lead to a wide variety of health problems such as memory loss and cognitive
decline (though none of these issues will happen overnight --it may take
several years for symptoms to show up).

Therefore, to stimulate the vagus nerve, you will have to ensure that you do
not suffer from any deficiencies. The best way to achieve this is by
maintaining a healthy diet. You need to break your sugar, coffee, and
caffeine addiction while using vagus nerve stimulation. You can replace
your coffee or soda with green tea, which contains L-theanine, a natural
amino acid that improves mental alertness without any side effects such as
jitters or sleeplessness because it is relaxing. And if you are addicted to
sugar, you should try to avoid it as much as possible.

In addition, when it comes to exercise, you should make sure that you are
pushing your body hard enough that it will have an effect on the fat and
muscle in your body. One of the easiest ways to do this is by exercising with
a heart rate monitor. You can buy heart rate monitors online or in a store.

Don't forget to drink lots of water during exercise. And when it comes to
eating healthy fats, olive oil and fish are great sources, while avocados and
nuts are also good sources of healthy fats.

When you try to stimulate your vagus nerve, you should also ensure that you
get the proper nutrients in your diet. This is because the vagus nerve is a
highly underrated part of our body that requires proper nutrition to help it
function at its optimum level. As we mentioned earlier, the vagus nerve
turns carbohydrates into energy while removing fat from the blood stream
and regulating blood pressure, heart rate and blood sugar levels (this
happens by releasing certain neurotransmitters). One of the most important
aspects of improving your health concerning the vagus nerve is avoiding
any deficiencies as much as possible.

Functions of the vagus nerve.

• Brain

The Vagus nerve works in the brain through the cranial nerve X. It affects
the regulation of different parts of the brain and has an effect on mood. The
brain can be stimulated by the vagus nerve through the brainstem and
vagus nerve. The brain and the vagus nerve communicate via
neurotransmitters such as acetylcholine, dopamine, and serotonin.
Moreover, the vagus nerve also has a connection with the sympathetic
nervous system. The sympathetic nerve is activated when we are stressed
or in danger. When the brain perceives a threat, it will also stimulate the
sympathetic (fight or flight) nervous system, and this changes our blood
pressure and heart rate so that we can defend ourselves from any real
danger.
• Neck

The vagus nerve begins in the brain stem in the medulla, then descends
down into the neck, and is connected with many structures such as the
heart, lungs, and stomach. The effect it has on these structures depends on
which branch of the vagus nerve it is stimulating. The neck is a very
important part of our bodies as it is connected with many vital organs, and
the vagus nerve is the connection between the brain and these organs.
Examples of structures that are affected by this nerve are the heart,
stomach, lungs, and digestive systems. Therefore, the vagus nerve has a big
effect on the function of these organs.

• Sensory functions

The vagus nerve is connected to the motor neurons in the brain and spinal
cord. This means that the nerve helps us with our sensory functions. The
sensory systems are important because they help us understand how our
bodies are working and how we can take appropriate actions based on this
information. For example, it is important for us to know what our heartbeat
sounds like so that we can react appropriately if we notice any problems
with our heartbeat (such as when we feel our heartbeat is too fast or too
slow). The vagus nerve also affects other areas of the body such as saliva,
stomach acid, and kidney function. Therefore, the vagus nerve is important
in helping us to maintain our body functions, and it also keeps us healthy.

• Special sensory functions

The vagus nerve helps to regulate our breathing and heart rate. This helps
us to remain calm, even when we are in danger. The vagus nerve also helps
to control body temperature and blood pressure which are important when
we are under threat. For example, if you are feeling stressed due to an
exam or you were told that you had cancer, your heart would start racing,
and you're breathing fast: These effects would lower your body temperature
so that it wouldn’t be so high as it is under stress. The sympathetic nervous
system can activate the fight or flight response. When this happens it will
change the blood pressure so that there is more blood being pumped
around the body, therefore, increasing the oxygen supply. This makes us
breathe quicker to supply our brains with more oxygen so that we can
defend ourselves. The vagus nerve helps to control these effects of the fight
or flight system.

• Motor functions

The vagus nerve is also connected to the motor neurons which help us
move. This can be used to help us when we are in danger. When we are
stressed, the vagus nerve can cause paralysis of our limbs so that we cannot
move and therefore will not be able to defend ourselves. This paralysis is
temporary, and it wears off when the danger has passed.

The vagus nerve helps to control these effects of the fight or flight system.

The vagus nerve is not just one nerve but a collection of sensory, motor, and
parasympathetic neurons that begin at the brain stem. The vagus nerve is a
mixed nerve. The motor component of the vagus nerve arises from neurons
within the nucleus ambiguous. These motor neurons are cholinergic and
project to the thoracic and abdominal viscera, causing them to contract in a
braking fashion; this slowing response generates an "anti-gravity" effect on
the visceral organs. Parasympathetic innervation of the heart arises from
cells in the central nervous system, including those that also innervate
smooth muscle tissues in other parts of the body: these cells are known as
"cardiac companion cells".

• Pharynx

The Vagus nerve crosses the pharynx leaving it on the right side. The vagus
nerve innervates the pharynx, which is responsible for swallowing (the
passage of food and liquid via the mouth into the esophagus) as well as
regulating breathing. Therefore, the vagus nerve is important in swallowing
because it stimulates the muscles required for this process. In addition, the
vagus nerve also improves the breathing mechanism.

The brain stem is the most important part of the central nervous system. It
is located at the base of the brain, and it consists of three parts: the medulla
oblongata, pons, and the tegmentum. The brain stem controls basic
functions such as consciousness, body temperature, and heart rate as well
as bodily movement. The vagal nerve plays an important role in some of
these basic functions including heart rate and body temperature regulation.
In addition to this, when we are in danger, our brains will activate our
sympathetic nervous system, but there isn’t anything that can stimulate our
parasympathetic nervous system (parasympathetic control of our heart and
digestive systems).

• Larynx

Vagus nerve – The vagus nerve innervates the larynx, in particular, the
vocal cords. When the vagus nerve is stimulated, it causes a small reflex
which causes vocal cords to close. The closure of the larynx creates a reflex
that raises blood pressure and also lowers heart rate. Therefore, some
functions of this nerve are stress related as we often feel an increase in
pressure in our necks when we are under stress. Thus, the vagus nerve is a
vital part of our body as it is involved in our breathing, speaking, and
swallowing.

The vagus nerve has many other functions that are not related to the fight
or flight response but are still important for our overall health such as
regulation of the respiratory tract and heart rate.

• Recurrent laryngeal nerve

The vagus nerve is numbered as the tenth cranial nerve. The vagus nerve is
located in the neck, and it is responsible for controlling some of the body's
most important functions: breathing and swallowing. The recurrent
laryngeal nerve is responsible for these two processes.

The larynx (or voice box) is at the top of the trachea leaving your skull to
enter your chest through your throat. The larynx ensures that air enters
your lungs. This helps you to keep oxygen in your blood when we are not
exercising or eating so that you can continue fighting for breath against an
attacker or when you are under huge amounts of stress. The larynx is not
just important in helping to save our lives but also in helping us to speak.

The recurrent laryngeal nerve is one of the nerves which arise from the
vagus nerve. It supplies the muscles of the larynx and its derivatives. The
recurrent laryngeal nerve supplies all the intrinsic muscles of the larynx
except for the cricothyroid muscle, which is innervated by a branch from C1
(first cervical segment).
The pharynx is made up of two tubes that run from our nose and mouth to
our stomach (and even smaller tubes on top leading from our nose to our
lungs). When we swallow food and water, it passes through these passages.

• Vocalis inner laryngeal nerve

The vocalis inner laryngeal nerve branches from the vagus nerve and
supplies the muscles of the larynx. The vocalis inner laryngeal nerve is
activated by the vagus nerve, and when it is active, it causes paralysis of
some muscles of the larynx. Moreover, it causes the adduction of the vocal
folds.

• Parasympathic functions

The skin of the neck is made up of a network of nerves that supply sensation
to the surface area above and below the surface of our skin. These nerves
are responsible for pain. For example, when you have a toothache, this is
because you have an infection in your body that has affected your nerve
endings on the skin (just like any other part of your body), so when you
touch this area, it causes pain in that part of your body. The vagus nerve
helps to control these effects of the fight or flight system.

Polyvagal theory
The polyvagal theory is a biopsychosocial model that integrates autonomic
nervous system functioning, social engagement behavior, and speech-
related breathing patterns. The theory postulates that these three
components of the body's
response to stress are regulated
by an evolutionarily ancient
system in mammals called the
vagus nerve. It is thought that
this system evolved from the
sympathetic nerve system,
which is responsible for
amplifying the effects of stress
throughout the body. This
system consists of two separate circuits: the parasympathetic and the
sympathetic.

The parasympathetic nervous system is activated when a person is relaxed

and in a passive state, such as when lying down or seated. It regulates the
functions of glands and organs, such as the heart, lungs, and digestive tract.
These functions are in "rest-and-digest" mode during periods of rest or
sleep.

The sympathetic nervous system is activated when an individual is engaged

in an intense and immediate response to stress, such as by fighting or
fleeing. This system maintains the body's active state during periods of
stress.

The polyvagal theory proposes that the interaction between these two
systems influences how an individual copes with life's daily stresses. For
example, in a person who experiences chronic anxiety or whose
parasympathetic circuit is poorly regulated, the threat, fear, or emotions
resulting from stress are amplified via the sympathetic system, and there is
little chance that this person will reach a relaxed state that could restore
their ability to handle stress.

The polyvagal theory is effective for treating individuals with depression

and panic disorders. In addition, clinical trials it has been shown to help
improve the treatment of pain and disorders such as asthma and PTSD.

The vagus nerve is one of the cranial nerves in the nervous system. It arises
from fibers from the brain that arise from parts of both sides of the brain
called the cortex (including frontal lobes). In humans and wolves, this nerve
begins in a bundle that includes fibers originating from each side of the
brain.

It runs in a direction lateral to the spinal column (away from the body) and
passes through a bifurcation at about level C4 or C5. These are called
"conduits for vagus."

• Common problems related to cranial-nerve dysfunction:

The problems that can arise from cranial nerves include the following:

a. Brainstem Compression
The brainstem is a collection of structures at the top of the brain. It controls
basic reflexes and functions like breathing, heart rate, and coordinating
movement. When problems arise in a part of the brainstem, these reflexes
can be disrupted and function poorly. For example, if part of the brainstem
gets compressed by a blood clot or tumor, there may not be adequate
control for breathing or heart rate. This condition is called cauda equina
syndrome (CES).

CES can be caused by several conditions, like spinal disc herniation (a bulge
on a nerve that compresses the spinal cord) or inflammatory diseases of the
vein that supplies blood to the brainstem (such as multiple sclerosis). It's
also related to cases in which tumors are pressing on nerves and causing
problems with breathing.

When there is compression in the brainstem, other functions may be

affected. For example, if one of the cranial nerves is compressed below the
level where it leaves the brainstem, it won't function properly.

b. Cranial Nerve Injuries

Cranial nerve injuries can affect the function of any one of the cranial
nerves. For example, a severe head injury can injure the brainstem and
damage any one of the cranial nerves that are passing through this area.
The most common cause of cranial nerve injuries is traumatic injuries such
as car accidents and falls.

c. Cranial Nerve Tumors

Several types of tumors can occur in parts of the brain in which some parts
of the brainstem lie. These tumors can be benign (non-cancerous), like
meningioma (cancer of the membranes that cover the brain and spinal
cord), or malignant (cancerous). In these conditions, the nerves may also
become compressed and damaged.

d. Hydrocephalus

Some children are born with an excessive amount of fluid in the brain. This
condition is called hydrocephalus. It's most noticeable when children are
young and may be treated by surgically draining excess fluid out of the
brain so that it can reabsorb into the ventricles of their brains (the spaces
inside their heads where cerebrospinal fluid collects). There are times,
however, when this condition is difficult to treat and can be fatal.
Hydrocephalus is also called "water on the brain."

e. Spinal Cord Injury

Damage to a person's spinal cord can break communication between the

brain and the rest of the body. This damage can occur from a fracture in the
spine that disrupts neural fibers that project from part of the spinal cord
called a gray column. Since both sides of this structure work together, any
damage here will affect both sides of the body and result in weakness or
paralysis.

g. Brain Abscesses

A brain abscess is an infection inside the skull that travels through one or
more small openings in the bones of that area (a sinus). Infection most often
causes this condition from bacteria entering the skull through a wound on
the skin or a dental abscess. A skull fracture located near these openings
may also be a contributing factor. The infection can travel up into the brain
and cause damage.

h. Carotid Arteriosclerosis

In carotid artery disease, "scarring" occurs at the base of the neck, where it
meets the aorta (the body's main artery). This "scarring" (atherosclerosis)
can lead to narrowing and serious problems with blood flow through one or
more of these arteries, which can cause strokes and heart attacks.

To prevent carotid artery problems, treatment is directed at decreasing the

risk factors. These include:

Other causes of compression in this area include a brain tumor or abscess.

This type of pressure can lead to symptoms including difficulty talking,
difficulty swallowing, and changes in vision that mimic a stroke.

18. Panic disorder- A panic attack is a sudden episode of intense fear that
occurs for no apparent reason and lasts for several minutes or even hours.
During these attacks, there are symptoms like palpitations, sweating and
trembling, shortness of breath, and dizziness. The person may believe they
have a heart attack or stroke.
• Emotional issues

This type of anxiety disorder is related to an unresolved conflict expressed

throughout the body. For example, a traumatic event from the past may
cause emotional reactions when it comes up as a trigger in everyday
situations or activities. It's common for sufferers to have physical health
issues such as chronic headaches, digestive problems, difficulty sleeping,
and loss of energy that may not be directly related to emotional conflicts.
Sometimes people with panic disorder suffer from physical health issues,
but their emotional struggles interfere with their ability to effectively treat
these issues.

One of the major functions of the vagus nerve is to relay messages between
the brain and the body. A problem with this nerve can cause various issues
related to this communication system. For example, if there's a problem
with sending signals to and from the brain, it might be difficult for someone
to feel their body or any sensations they are experiencing. This can lead to
emotional reactions aimed at getting attention or helping with recognizing
physical sensations. This may be expressed through anxiety, anger, and
irritability. In addition, being "out of touch" with your body can cause
emotional reactions when events occur that feel scary or distressing (for
example, in a panic attack). Vagus nerve problems can also affect how
someone experiences emotions. For example, someone with a vagus nerve
problem might experience a surge of adrenaline when in danger, resulting
in feelings of panic or arousal.

It's not uncommon for people to develop conditions that affect their vagus
nerve and relate to worrying and anxiety. For example, the tilt table test
can evaluate balance issues by having patients lie on a tilt table under
stable conditions. If problems are found in this area, they can be caused by
various factors, including many medical conditions such as diabetes or
Parkinson's Disease, as well as some psychological ones such as anxiety,
depression, and post-traumatic stress disorder. Some medications have also
been linked to this condition (like nicotine and neuroleptics).

What happens if the vagus nerve is damaged?

The Vagus nerve is the longest cranial nerve that connects the brain to the
abdomen. It sends a branch that goes to the heart in addition to going south
of the diaphragm and up to the chest.

The Vagus nerve’s function controls motor function. Still, it also controls
important processes such as regulating blood pressure, causing coughing
and swallowing saliva, helping respiratory organs work better with emotion
regulation, and it helps control our heart rate.

It affects not only all these processes but also our ability to see, hear, speak
or understand language because all of these functions are controlled by one
vagus nerve.

This nerve also may decrease our sexual function because it is needed for
orgasm.

The vagus nerve connects the brain to the body through the phrenic nerve,
which is connected to the diaphragm. This vagus nerve, in addition to being
needed for breathing and heart rate control, is also important in many other
ways.

The vagus nerve controls many processes in your body, and without it, those
processes will not be able to work properly. For example, without its
operation, it would be difficult for you to have a normal heart rate or the
ability to eat and drink normally.

If the vagus nerve is damaged, it may activate the sympathetic nervous

system. This system is responsible for raising your blood pressure and
heart rate. It also stops you from making the digestive juices in your
stomach that help you digest foods properly. These functions are not only
important for people who are injured or sick, but they are also vital to
everyday life.

The vagus nerve connects the brain to the body through the phrenic nerve,
which is connected to the diaphragm. This vagus nerve, in addition to being
needed for breathing and heart rate control, is also important in many other
ways.

The vagus nerve controls many processes in your body, and without it, those
processes will not be able to work properly. For example, without its
operation, it would be difficult for you to have a normal heart rate or the
ability to eat and drink normally.

If the vagus nerve is damaged, it may activate the sympathetic nervous

system. This system is responsible for raising your blood pressure and
heart rate. It also stops you from making the digestive juices in your
stomach that help you digest foods properly. These functions are not only
important for people who are injured or sick, but they are also vital to
everyday life.

Therefore, the following effects can be experienced if this nerve is

damaged:

1. Increase in blood pressure and heart rate

Blood pressure and heart rate are both controlled by the sympathetic
nervous system. If we damage this nerve, the brain will send signals to our
sympathetic nervous system, which will then cause our blood pressure to be
regulated, and our heart rate will increase.

2. Decrease in ability to breath

The vagus nerve connects the brain to the body through the phrenic nerve,
which is connected to the diaphragm. This vagus nerve, in addition to being
needed for breathing and heart rate control, is also important in many other
ways.

The vagus nerve controls many processes in your body, and without it, those
processes will not be able to work properly. For example, without its
operation, it would be difficult for you to have a normal heart rate or the
ability to eat and drink normally.

If the vagus nerve is damaged, it may activate the sympathetic nervous

system. This system is responsible for raising your blood pressure and
heart rate. It also stops you from making the digestive juices in your
stomach that help you digest foods properly. These functions are not only
important for people who are injured or sick, but they are also vital to
everyday life.

3. Difficulty breathing during sleep

If your vagus nerve is damaged, you will experience difficulty breathing
during sleep. As a result, you will wake up more frequently from sleep and
have a lower level of quality your sleep. You may also experience chest pain
when sleeping and even have higher blood pressure levels in your body at
night.

4. Difficulty swallowing saliva

If the vagus nerve is damaged, it can decrease the saliva you swallow
during your day compared to other people because it controls the muscles
in your throat so you can swallow properly. This helps with swallowing
foods and drinking water.

5. Difficulty seeing and hearing during certain times of day

The vagus nerve connects the brain to the body through the phrenic nerve,
which is connected to the diaphragm. This vagus nerve, in addition to being
needed for breathing and heart rate control, is also important in many other
ways.

The vagus nerve controls many processes in your body, and without it, those
processes will not be able to work properly. For example, without its
operation, it would be difficult for you to have a normal heart rate or the
ability to eat and drink normally.

If the vagus nerve is damaged, it may activate the sympathetic nervous

system. This system is responsible for raising your blood pressure and
heart rate. It also stops you from making the digestive juices in your
stomach that help you digest foods properly. These functions are not only
important for people who are injured or sick, but they are also vital to
everyday life.

6. Difficulty speaking and understanding language

If the vagus nerve is damaged, it can decrease your ability to speak and
understand language because it controls many of your speech functions,
such as breathing and heart rate control, as well as language functions in
the brain, such as vision, hearing, and recognition.

7. Difficulty swallowing and eating normally

The vagus nerve connects the brain to the body through the phrenic nerve,
which is connected to the diaphragm. This vagus nerve, in addition to being
needed for breathing and heart rate control, is also important in many other
ways.

The vagus nerve controls many processes in your body, and without it, those
processes will not be able to work properly. For example, without its
operation, it would be difficult for you to have a normal heart rate or the
ability to eat and drink normally.

If the vagus nerve is damaged, it may activate the sympathetic nervous

system. This system is responsible for raising your blood pressure and
heart rate. It also stops you from making the digestive juices in your
stomach that help you digest foods properly. These functions are not only
important for people who are injured or sick, but they are also vital to
everyday life.

8. Trouble swallowing foods and eating properly

If the vagus nerve is damaged, you may have difficulty swallowing certain
types of foods like those that require large amounts of chewing since the
food will not be properly mixed with saliva or it will not be mixed correctly
due to complications from changes in the esophagus caused by damage to
this nerve.

9. Vomiting during sleep and severe nausea

The vagus nerve connects the brain to the body through the phrenic nerve,
which is connected to the diaphragm. This vagus nerve, in addition to being
needed for breathing and heart rate control, is also important in many other
ways.

The vagus nerve controls many processes in your body, and without it, those
processes will not be able to work properly. For example, without its
operation, it would be difficult for you to have a normal heart rate or the
ability to eat and drink normally.

If the vagus nerve is damaged, it may activate the sympathetic nervous

system. This system is responsible for raising your blood pressure and
heart rate. It also stops you from making the digestive juices in your
stomach that help you digest foods properly. These functions are not only
important for people who are injured or sick, but they are also vital to
everyday life.

10. Difficulty swallowing saliva

If the vagus nerve is damaged, it can decrease the saliva you swallow
during your day compared to other people because it controls the muscles
in your throat so you can swallow properly. This helps with swallowing
foods and drinking water.

11. Trouble speaking and understanding language

If the vagus nerve is damaged, it can decrease your ability to speak and
understand language because it controls many of your speech functions,
such as breathing and heart rate control, as well as language functions in
the brain, such as vision, hearing, and recognition.

12. Tingling, numbness, and pain in the face

If the vagus nerve is damaged, it can decrease your ability to speak and
understand language because it controls many of your speech functions,
such as breathing and heart rate control, as well as language functions in
the brain, such as vision, hearing, and recognition.

13. Loss of balance when walking or standing still

The vagus nerve connects the brain to the body through the phrenic nerve,
which is connected to the diaphragm. This vagus nerve, in addition to being
needed for breathing and heart rate control, is also important in many other
ways.

The autonomic nervous system’s three circuits.

More than any other part of the body, the vagus nerve is responsible for
regulating our digestive and respiratory systems. It helps control what we
perceive as emotions, from fear to anger. It’s also involved in regulating our
heart rate and blood pressure, maintaining the heart rhythm, and
controlling major organs like your liver.
Another important function of this nerve is memory storage — it connects
back to our hippocampus, which plays a significant role in long-term
memory formation. This means that when we are under stress or
experiencing an emotional event, one circuit of this nerve can release
neurotransmitters that lead to increased activity on the other two circuits,
leading to euphoria or terror, respectively.

The three circuits are essential since they are interactive and depend on
each other for optimal function. This includes all the circuits of the
autonomic nervous system, including the enteric nervous system.

In this book, we are going to focus on circuit one. This is often referred to
as the fight-or-flight response, which separates humans from all other
mammals. This is a powerful circuit, and it can be overwhelming and
debilitating when we become stressed.

Along with learning about the first circuit, we will also look at some tools
and strategies for managing stress levels in your life. Because without them,
you will never truly reach that state of peace you desire and need.

These autonomic nervous system’s circuits include:

a. sympathetic nervous system

The sympathetic (fight-or-flight) response is our main tool for dealing with
stress when it is overwhelming or harmful to our survival. The sympathetic
(fight-or-flight) response is triggered when the brain detects an “alarm” that
something is wrong — as in, “something bad” has happened or might
happen very soon in the future. So what does that mean? It means that
something bad has happened or might happen very soon in the future,
which could threaten your survival. So what do you do? You withdraw, fight,
and defend yourself.

We are here on this earth to survive, and the fight-or-flight response is a

very effective tool that we use to protect ourselves. It is our “escape-and-
defend” system when we need it most. When called upon, the body
produces an immediate surge of adrenaline and cortisol -a hormone that
prepares us for protection from threats. This is also called the “startle
reflex.”
Our bodies create this partly because of positive feedback loops inside our
brains . When the stress is over, this system overreacts and produces two
hormones, adrenaline, and cortisol. They are hormones meant to be
released in stressful or dangerous situations. While cortisol may have a
purpose in short spurts during an emergency, prolonged exposure can have
undesirable effects.

"It is important for people to become aware of their fight-or-flight response.

It is a survival reaction that activates our heightened awareness of danger,
increasing blood flow and metabolism in the areas of the body associated
with danger. This is especially true of the heart, skeletal muscle, and gut. It
will wear out if we do not use this protective mechanism for long enough
periods.

b. Parasympathetic nervous system

The parasympathetic nervous system has a calming effect on the body. It

helps to restore balance to the body and mind. This is activated when an
“alarm” isn’t detected about danger or stress.

This has two major effects:

- Cortisol levels are reduced

- Heart rate, blood pressure, and respiration slow down

This system also has other effects, like activating the digestive processes,
including releasing enzymes and hormones that stimulate the pancreas to
secrete insulin and glucagon. While this positively affects our bodies, it can
lead to problems if not used properly. Therefore, it’s best to use the
parasympathetic nervous system as much as possible.

The two components of the parasympathetic nervous system are:

1) Cranial nerves (CN) III, VII, IX, and X — release neurotransmitters that
act on the heart, lungs, and digestive system.

2) Somatic nervous system — this is the one we will focus on here.

The Somatic Nervous System

This system senses what your body feels and sends messages to the brain,
which then sends signals to your muscles. It uses feedback loops, such as
stretch reflexes, so the brain receives information about how things affect
you.

The sympathetic nervous system is triggered by a change in sensations in

the body that indicate stress, threat, or danger. The parasympathetic
nervous system works to get us back into balance again after being released
from stressful situations. It’s not a conscious response, so it’s usually
unconscious.

c. enteric nervous system

The ENS is composed of an extensive network of neurons that control your

body’s internal system, with millions of neurons within this system. While it
is a part of your peripheral nervous system, it is considered autonomous.
This means that its functions can operate independently of your brain and
spinal cord .

It is made up of two parts:

These neurons control several activities, including:

- Digestion

- Motility

- Absorption

- Secretion

It’s connected to the sympathetic and parasympathetic nervous systems, so

these three systems are interconnected. Moreover, it has one end
connected to the brain and the other to the rest of your digestive tract. This
means that it can help control both processes in your body, which is vital for
it to perform optimally.

In this circuit, we will focus on learning how this system controls gut
function. This will help you understand how your body functions in digestion
and, more importantly, allow you to understand why things work the way
they do.
The ENS consists of two parts:

1) Dorsal ganglion — this is where neurons from your sympathetic nervous

system connect and control your immune system. It also helps control blood
pressure .

2) Pedunculopontine nucleus — this is the part of your ENS that controls

your gut.

The PN is made up of neurons that control the following functions:

- Both the sympathetic and parasympathetic nervous systems

- Gastroenterology

- Motility

- Secretion (including saliva)

When it comes to digestion, it’s usually referred to as the enteric nervous

system. It’s a very small system that runs through your entire
gastrointestinal tract from mouth to anus. It is composed of two parts:

1) Dorsal nerve plexuses — these are located in various areas within your
gut, from mouth to anus.

2) Ganglia — these create a network composed of afferent and efferent

fibers, which means they can either receive information or send messages.

When you are born, the PN contains more cannabinoid receptors. It uses
endocannabinoids as a neurotransmitter. As you age, it decreases in these
receptors but increases in substance P receptors.

This system serves as your body’s main regulator for the following
activities:

- Digestion — helps control all gastrointestinal functions and is responsible

for maintaining homeostasis. This refers to when something becomes
balanced again after being disturbed by some factor outside your body.

Homeostasis and the autonomic nervous system.

The Vagus Nerve is a part of the Autonomic Nervous System, which
innervates both the Sympathetic and Parasympathetic. It controls the rate
of blood vessels pulsing in the gut, heart, and digestive systems.

It is involved in controlling lactation and menstruation cycles. Vagus nerve

stimulation is used to try to control seizures.

The Vagus Nerve has branches that go into a multitude of organs, including:

Heart, lungs, stomach, intestines, kidneys, liver, spleen, thymus, and

kidney's adrenal glands.

It is a diagnostic tool to look at the heart's health. One of its branches goes
into the heart and becomes a branch of the Sympathetic nervous system.
When there is something wrong with the Vagus Nerve, it will not be sending
information to the Sympathetic nervous system.

This will cause the heartbeat to slow and possibly stop, which could lead to
death if not treated. The Vagus Nerve can also be used as a treatment for
severe seizures (eclampsia and tonic-clonic).

It is used in surgery when it comes into contact with blood because it can
cause clotting; otherwise, it is safe to use.

The Vagus nerve is also used as a diagnostic tool to examine the heart's
health.

One of its branches goes into the heart and becomes a branch of the
Sympathetic nervous system. When there is something wrong with the
Vagus Nerve, it will not be sending information to the Sympathetic nervous
system.

This will cause the heartbeat to slow and possibly stop, which could lead to
death if not treated. The Vagus nerve can also be used as a treatment for
severe seizures (eclampsia and tonic-clonic). It is used in surgery when it
comes into contact with blood because it can cause clotting; otherwise, it is
safe to use.

The Vagus Nerve is a critical part of the Autonomic nervous system. The
Autonomic Nervous System is the part of the nervous system that acts
through the nerves. The branches of the nerve that go into different organs
make up its Parasympathetic and Sympathetic sides. It is located in the
brain's central core, located between the two hemispheres, and goes to both
sides.

Homeostasis is the ability of the body

to maintain a stable internal
environment. It is affected by the
Autonomic Nervous System.
Homeostasis is controlled through
homeostatic receptors in a process
known as negative feedback. The
body will have an ideal temperature, a
normal pH level, and a steady
heartbeat rate. When there is any change to these three key factors, then it
will send out signals of change to other parts of the body that are
responsible for maintaining homeostasis. This can happen on its own or
with another signal from outside forces.

Homeostatic receptors have a mechanism of action that regulates changes

in the central nervous system. When there is a change in the body's normal
homeostatic substances, they will trigger signals that travel along the vagus
nerve. These signals travel with the vagus nerve to other body parts, such
as the heart and lungs. Suppose an organ has not received these messages
from its cells. In that case, it will automatically receive a signal from
another part of the body when it does not have a homeostatic receptor for
them on its own.

To function, various organs and systems need certain chemicals normally

found in blood or tissue fluids. The organs and systems must maintain
homeostasis of all these chemicals. Chemical and Hormonal signals can
affect the function of other organs.

Electrical imbalances within the autonomic nervous system can affect how
we interact with our environment. If there is an imbalance in
neurotransmitters, homeostasis will not be maintained. For example,
depression is caused by a chemical imbalance within the nervous system
that affects neurotransmitters in the brain.
The Autonomic Nervous System mostly regulates itself through feedback
loops that allow it to remain stable. The Autonomic Nervous System consists
of two parts. The Parasympathetic and Sympathetic Nerves.

The brain has two sets of nerves: the Sympathetic and the Parasympathetic.
The nerves are responsible for many of their actions, whether a fast or a
slow response. If there is no nerve activity, the body can still function, but a
slow one can lead to death.

The vagus nerve is sometimes called the longest nerve because it runs from
the brain to other organs in your body; this includes parts such as the
Heart, Lungs, and Stomach's digestive system.

Therefore, the Autonomic Nervous System carries out homeostasis through:

a. Negative feedback -The nerve impulses the organs and systems receive
will automatically stop any chemical or hormonal signals at the right time to
maintain homeostasis.

b. Positive feedback - The Autonomic Nervous System can regulate itself

through many different pathways, but most deal with minimizing chronic
stress on the body.

c. A combination of negative and positive feedback - When the Autonomic

Nervous System can maintain homeostasis, it will function properly because
the chemical and hormonal pathways that control organs and systems will
run smoothly.

The Autonomic Nervous System is a very complex system that works almost
miraculously to keep the body functioning.

The Autonomic Nervous System regulates itself, but there are times when it
might need help from outside influences to maintain homeostasis. Some of
the main causes of malfunctioning can be:

a. Head injury - The amount of blood flow to the brain can change following
a head injury, which can affect the Autonomic Nervous System, causing
malfunction.

b. Heart disease - Heart disease can affect the Autonomic Nervous System
because it affects the oxygen supply to your entire body.
c. Parkinson's Disease - The brain's dopamine pathways are affected by
Parkinson's disease, which can affect the Autonomic Nervous System,
causing malfunction.

d. Diabetes - Type 1 and Type 2 diabetes can cause malfunctioning of the

Autonomic Nervous System by increasing chemical imbalances.

e. Liver Disease - Liver failure can also cause malfunctioning of the

Autonomic Nervous System because it affects its ability to regulate
chemicals that control such processes as breathing and blood pressure.

f. Severe Trauma - Severe trauma can also cause malfunctioning of the

Autonomic Nervous System because it affects the chemical pathways that
control your organs and systems.

g. Infection - Infections can also cause malfunctioning of the Autonomic

Nervous System by affecting the chemical pathways that control your
organs and systems.

h. Brain Injury - Brain injuries can also cause malfunctioning of the

Autonomic Nervous System because it affects the chemical pathways that
control your organs and systems.

i. Other illnesses - Other illnesses can also affect the Autonomic Nervous
System, causing malfunctioning because they affect other parts of your
body, such as the heart or lungs, through chemical imbalances.

j. Drugs - Drugs can also cause malfunctioning of the Autonomic Nervous

System by affecting chemical and hormonal pathways that control organs
and systems.

The Autonomic Nervous System is a very complex system that works almost
miraculously to keep the body functioning. The system's three main
components are Sympathetic Nerves, Parasympathetic Nerves, and
Homeostatic Receptors. When you combine these three main components in
one system that self-regulates itself, then it allows your body to do many
things on its own such as: regulating heart rate and blood pressure,
controlling digestion, controlling breathing, etc.

The Autonomic Nervous System is responsible for regulating many body

functions, such as heart rate, blood pressure, and digestion. This system
continuously monitors and adjusts these functions to keep them within a
normal range.

This system can be broken down into two parts: the sympathetic and
parasympathetic systems. The sympathetic and parasympathetic nervous
systems are not working all the time simultaneously; they are always one or
the other. One part working while the other part is resting helps regulate
your body's functions to remain balanced.

The Autonomic Nervous System regulates many body functions, which it

controls through feedback loops involving negative and positive feedback
mechanisms.

The autonomic nervous system has a wide range of functions. Some parts of
the brain are stimulated by it, such as:

a. Cerebral Cortex

b. Limbic System - The Limbic System is located deep within the brain and
regulates emotion, memory and learning, behavior, and motivation

c. Hypothalamus – The hypothalamus controls all pituitary functions such as

body temperature regulation; hunger, thirst; sleep cycles; sex drive, and
emotional responses

d. Spinal Cord and Nerves – The spinal cord is the main communication
pathway between the brain and body.

Five states of the autonomic nervous system.

The autonomic nervous system comprises two divisions—the sympathetic
and the parasympathetic systems. The sympathetic activates organs that
release neurotransmitters, while the parasympathetic inhibits organs that
release neurotransmitters.

The enteric (or ventral) vagal nerve lies between the brain and the stomach.
It is responsible for regulating heart rate rhythm, among other things, as
well as visceral functions like digestion. Its activity can be detected in other
body parts by a change in heart rate or blood pressure.

The five states of the ANS include:

1. Sympathetic response

The sympathetic response is activated during periods of stress and rapid

physical activity. It increases heart rate and the force with which the heart
contracts. It relaxes the smooth muscles of the bronchi, allowing the
airways to dilate. The skeletal muscles are activated by sympathetic fibers,
increasing their tone and making them contract more forcefully. The pupils
of the eyes dilate, and perspiration increases. Blood flow is directed toward
major muscle groups and away from organs not involved in physical activity
(the "fight-or-flight" response). Moreover, the blood is shunted away from
the skin into the muscles, making it pink and warm. The end result of this
activation is more energy.

Therefore, this response is essential since it provides the vital energy

required for "fight-or-flight" situations. The hypothalamus and the
brainstem control the sympathetic system. The effect of this response is
mediated through the release of various hormones into the bloodstream.

2. Parasympathetic response

The parasympathetic response (also called the "rest and digest" response)
activates organs that release neurotransmitters while inhibiting organs that
release neurotransmitters. Specifically, this system increases the activity of
the salivary glands, stomach, and intestines. It also inhibits respiration and
digestion, making your belly relax, increasing blood flow to the muscles,
and decreasing it to the skin. The pupils of the eyes constrict, secretions
decrease, and heart rate slows down. Therefore, this system is responsible
for restoring energy spent during activity in times of rest or relaxation. This
response aims at preserving energy.

The hypothalamus and the brainstem control the parasympathetic response.

The effect of this response is mediated through the release of various
hormones into the bloodstream.

This response is vital in waking and certain aspects of consciousness

(alertness). It promotes digestion and absorption, relaxes smooth muscles
throughout the body, helps maintain a healthy immune system, and keeps
blood glucose levels within a normal range. This system also plays an
important role in sexual arousal.
As you will see in the next section, the parasympathetic response is
associated with subjective feelings of calmness and relaxation. The
parasympathetic system is called the "rest and digest" system because it
conserves energy for future demands. When this system is activated, it
reduces heart rate, lowers blood pressure, and dilates pupils.

The enteric (or ventral) vagus nerve supplies the gastrointestinal tract and
activates an increase in peristaltic action within its walls. In addition, it
regulates the secretion of gastric acid and pepsinogen (an inactive form of
pepsin). When this nerve is activated, gastric motility and gastric secretions
are increased. The vagus nerve is central to controlling blood pressure by
the brainstem.

This nerve also regulates the contraction of muscles in the esophagus and
stomach and relaxes them when it decreases activity. The vagus nerve is
considered a major component in the gut-brain axis regulating digestion. It
coordinates other organ activities, like breathing, heart rate, muscle
movement, and mood.

3. Reticular Stimulation

The third state of the autonomic nervous system is termed reticular

stimulation. It occurs when a stimulus activates a large area of several
sensory fibers that come into contact with the same nerve endings—the
proprioceptive afferents to the CNS (central nervous system). The efferent
fibers from these sensory afferents then pass through many ascending
tracts, synapses, and interneurons, all in rapid succession to arrive at their
point of origin.

For example, the Alpha1 (α1) receptors on the blood vessels will respond to
stimulation from a drug that blocks the inhibitory effects of acetylcholine at
that point in the body. When this happens, acetylcholine will be released
through the parasympathetic system, and it will cause vasodilation at this
point of origin.

The term reticular stimulation is derived as an analogy to one's thoughts:

one has many thoughts, but they are organized in such a way that they can
be grouped into complex thought patterns called "patterns" or "schemas."
A certain stimulus (like food or drink) will activate several receptors along
the course of their afferent fibers back up to their origin point. This will lead
to a series of afferent impulses that then converge and send one single
efferent impulse through a descending pathway (or "reticulum"). However,
the efferent fibers do not all arrive simultaneously at their point of origin.

They will sometimes arrive so rapidly that they cannot be distinguished.

This is called coactivation. Furthermore, synchrony is associated with these
impulses, an effect called common excitation (or shared excitation).

Reticular stimulation can also refer to the complex network of ascending

axons with which these afferent fibers travel. The network consists of
individual parallel or serial nerve pathways or tracts that form the
ascending reticulum. Some are sensory tracts, while others are part of the
motor system.

This reticular stimulation is responsible for the effect of sedation that one
may feel due to opiates (or opioids) or other drugs. These drugs have a high
affinity to either α1-adrenergic receptors on blood vessels or κ-opioid
receptors on nerves within the CNS (central nervous system).

The former mechanism can cause vasodilation, a lowering of blood

pressure, and a reduction in pain. Moreover, the latter can cause sedation,
mood changes, and dysphoria with prolonged use. However, when both
these mechanisms work simultaneously to produce this effect, they tend to
be additive in their effects.

4. Sympathetic Stimulation

Sympathetic stimulation refers to activating the sympathetic division of the

autonomic nervous system. This response is also known as fight or flight. It
prepares an organism for dealing with a threat by activating various
physiological systems, including cognitive and behavioral changes. These
changes allow the organism to respond effectively to a threat, typically by
fighting or running away from it.

A stressor that can lead to this sympathetic response is typically one that
threatens an organism's well-being and causes fear, which then triggers this
response through the brain's limbic system. For example, a loud noise or
impending collision can trigger this response. This response will cause
various physiological changes, including increased heart rate and blood
pressure, faster breathing, and higher glucose levels in the bloodstream.

Exercise can also trigger sympathetic stimulation (such as sprinting to

escape danger). It is vital in the "fight-or-flight" response of the nervous
system. However, if stimulated for too long, it can have harmful effects
(such as hyperthermia).

The sympathetic stimulation can also cause constriction of the bronchi in

the lungs, which helps to increase the force of contraction during exhalation
(EVC).

5. Immune response

The immune response is the reaction of an organism to invasion by

pathogens. It involves both non-specific and specific responses. The non-
specific response consists of the body's natural, inborn defenses; it is found
in plants and animals, and fungi (such as yeast). These defenses include
physical barriers such as the skin, chemical barriers such as acids and
enzymes, and biological barriers; for example, inflammatory responses and
the production of antibodies.

The non-specific response does not involve the activation of specific immune
cells but rather the activation and mobilization of various other cell types to
restrict the spread of pathogens.

The specific response is a more targeted immune reaction that activates

certain white blood cells, or lymphocytes, to destroy foreign substances.
This adaptive reaction prepares the immune system for future challenges by
producing memory T and B lymphocytes.

This section discusses two types of responses: nonspecific responses and

specific responses (both cellular). The nonspecific response is not as
effective as the specific response.

6. Nonspecific response

The nonspecific response is the most common type of immune reaction and
involves both humoral and cellular immunity. It responds to foreign or
otherwise threats by activating special white blood cells (antibodies) to
recognize the invader. These antibodies are made in the immune system's
B-cell lymphocytes, which reside in the bone marrow (or lymph nodes).

For this reaction to occur, a "foreign" substance must first activate these
white blood cells. This substance is usually a molecule from an invader.

This can be achieved by administering two different types of drugs: A drug

that initiates the B-cell reaction. The molecule that initiates this response
must be specific for the particular invader and not for another substance
(such as a chemical or drug). This is called "antigenic specificity." The
second drug can inhibit this response. It has no antigenic specificity, but it
delays the reaction.

The three neural pathways of the ANS.

The autonomic nervous system (ANS) is composed of two opposing systems
that control the constriction and dilation of blood vessels. The ANS is a
subsystem of the peripheral nervous system, which controls unconscious
activities in organs such as digestion, circulation, respiration, and urine
production. The ANS regulates body functions necessary to sustain life by
controlling heart rate, breathing rate, salivation levels, and perspiration
rates.

The ANS includes two opposing systems. The sympathetic nervous system
operates through the release of norepinephrine, constricting blood vessels
and increasing the heart rate. The parasympathetic nervous system
operates through the release of acetylcholine, which widens blood vessels
and slows down the heart rate. Both systems are responsible for
maintaining body functions necessary to sustain life. The ANS is a
subsystem of the peripheral nervous system, but it also receives input from
several glands (e.g., pituitary) via hormones secreted into the bloodstream
by those organs. These hormones are called autocrine or paracrine
hormones. The peripheral nervous system is composed of nerve bundles
that transmit impulses to and from our organs. The ANS acts on two
opposing systems to control blood flow, heart rate, and other functions.
1. The autonomic nervous system

The sympathetic nervous system operates

through the release of norepinephrine. This
action causes constriction of blood vessels
using alpha motor neurons (α-neurons)
(sometimes called the "suck" pathway). The
α-neurons serve as the muscles of the
vascular system, causing blood vessels to
constrict by firing action potentials called
"myocardial contractions" (MCPs) that shrink
the diameter of blood vessels.

The parasympathetic nervous system

operates through the release of acetylcholine.
This action causes dilation of blood vessels
using cholinergic neurons (sometimes called
the "push" pathway). These neurons slow
heart rate by causing blood vessels to open
up rather than contract.

The Vagus nerve is a paired nerve that extends from the medulla in the
brain down to thoracic vertebrae T1–T9 and lumbar vertebra L3. The nerve
branches into the left and right vagus nerve in the thoracic and lumbar
regions of the spinal cord. Each vagus nerve continues into the abdomen,
supplying many of the viscera with nervous projections.

The Vagus Nerve carries fibers from sympathetic and parasympathetic

pathways to organs in the chest cavity and abdomen. The autonomic
nervous system controls bodily functions such as digestion and breathing
that are not under conscious control. As its name implies, the ANS is
controlled by the autonomic nervous system, which sends impulses from the
brain to organs in the body that control these functions.

The ANS is composed of two opposing systems called sympathoadrenal and

parasympathetic. In this diagram, sympathetic fibers are shown in black,
and parasympathetic in white.
Each system of nerves has inputs from most major glands that secrete
various hormones into the bloodstream. These hormones are called
"autocrine or paracrine." The function of hormones secreted by glands is
affected primarily by neural input from central and autonomic nerves. The
peripheral nervous system is composed of nerve bundles that transmit
impulses to and from our organs. The ANS acts on two opposing systems to
control blood flow, heart rate, and other functions.

The autonomic nervous system (ANS) is a subsystem of the peripheral

nervous system that regulates internal organs' functions. The ANS has
several components that work together to ensure a regulated and steady
output of nerve impulses to the organs they supply. These components
ensure cardiovascular homeostasis, gastrointestinal motility, respiratory
control, urination, and kidney function.

A simplified diagram of the ANS is shown in figure 2. The sympathetic

nervous system includes nerves that receive stimuli from the hypothalamus
and pass information onto the thoracolumbar center (T2–L2).

2. The sympathetic nervous system

If either of these two systems fails (i.e., if they are dysfunctional), a

compensatory pathway is triggered. This compensatory pathway is called
the parasympathetic nervous system,
sometimes called the "rest and
digest" pathway.

For example, if the sympathetic

nervous system fails to function
properly, then the patient will
experience restlessness. The "rest
and digest" pathway compensates for
this by causing the release of
hormones into the bloodstream that
cause relaxation of the smooth
muscles of blood vessels, thus
increasing their ability to open
wider.
This is known as negative feedback regulation: a signal across a biological
interface such as a nervous system (or other) receptor or "feed-forward."
When used in the physiology-the flow of ions through phospholipid
membranes in cell membranes (for example), this feedback is not exactly
"negative." Still, it can be described as a faster than normal/desired
cancellation of an excitation signal. Negative feedback regulation is used to
achieve homeostasis- the state of a system that has constant conditions and
maintains itself as best in that environment.

Physiological homeostasis requires the nervous system to regulate the flow

of nutrients and other substances. This is achieved through a negative
feedback regulation feedback mechanism because the nervous system can
shut down sympathetic responses at the start or end of a burst to minimize
these effects. At first, this seems counterintuitive, but homeostatic
regulation does not always lead to a positive result, as it does with anabolic
steroids, where increased muscle mass leads to negative outcomes such as
loss of skin elasticity, tendon strength, and joint stability due to steroid-
induced atrophy.

3. The endocrine system

The endocrine and autonomic nervous systems (ANS)

work in tandem to help an organism maintain
homeostasis. The ANS is part of the peripheral
nervous system, which connects the central nervous
system to every body tissue. The central nervous
system has two divisions, the brain, and spinal
cord, which are not physically connected to any
other body part. It is thus a closed loop, a
network that creates and stores information. The
brain thus can retain information while constantly
receiving new information from outside systems
such as the ANS, immune system, and sensory
organs.

The ANS helps control many physiological processes by regulating the

actions of smooth muscles, cardiac muscles, and glands. It also interacts
with the endocrine system to create homeostasis. The ANS comprises two
subdivisions: the sympathetic nervous system, responsible for stress and
"fight or flight" responses, and the parasympathetic nervous system, which
has a general relaxing effect on the body.

The ANS plays an important role in maintaining the balance between

opposite or contrary forces in a biological system. For example, it controls
blood pressure by constricting arteries and expanding veins in response to
certain stimuli.

In this way, it maintains blood pressure within an acceptable range that can
vary during daily life (e.g., in stress response) but is kept constant within
the limits of a normal day-night cycle.

The ANS regulates blood pressure by increasing peripheral resistance and

decreasing cardiac output. It also reduces blood flow to the skin and sweat
glands by dilating arterioles.

These changes increase blood pressure (BP). The balance between the
parasympathetic and sympathetic branches determines whether BP
increases or decreases. For example, veins are constricted during
sympathetic stimulation so that less venous return can occur, thus
decreasing stroke volume and cardiac output. This then results in an overall
decrease in BP. Similarly, veins are dilated during parasympathetic
stimulation to allow for increased blood return to the heart, increasing
cardiac output, and BP.

The ANS system plays a role in blood glucose maintenance. When

consumed, glucose must enter the liver and be converted into glycogen.
This is done through gluconeogenesis in the liver and epinephrine-mediated
activation of glycogen synthase in the muscle cells. Suppose more glucose is
needed than can enter the peripheral tissues through glycogen synthesis or
epinephrine-mediated activation of glycogen synthase occurs. In that case,
this excess must be stored as fat tissue by fatty acid oxidation in adipose
tissue.

The sympathetic nervous system and the parasympathetic nervous system

both play a role in regulating glucose homeostasis. When carbohydrates are
consumed, insulin is released from the pancreas, and insulin causes an
increase in glucose transport into muscle and adipose cells. The
sympathetic nervous system causes an increase in epinephrine, which
increases glycogen synthesis. Epinephrine also helps decrease fatty acid
oxidation.

The ANS controls blood pressure and heart rate through the sympathetic
and parasympathetic divisions. Both divisions influence blood vessels by
causing them to constrict or dilate. The parasympathetic division increases
heart rate while decreasing the force of contraction; it decreases BP by
decreasing peripheral resistance through vasodilation of blood vessels.

The two-hybrid circuits of ANS.

ANS circuits pass electrochemical signals from the vagus nerve to the
nucleus or the solitary tract in a somatomotor neuron, an arm or leg muscle.
The neurons in these circuits are excited by sensory input of a stimulus,
such as a touch, vibration, temperature, sound, and taste. The vagus nerve
receives input from several senses and sends output to an ANS circuit that
will initiate an autonomic response when it receives an appropriate signal.

The ANS consists of a cluster of vagus nerve endings located in the

brainstem's medulla oblongata, along with sympathetic preganglionic
neurons that innervate local tissues. These two neuronal pathways can
function independently or in combination to trigger various autonomic
responses.

Claude Bernard first described the ANS in 1859. The dual electrical
stimulation of the vagus nerve causes muscle contraction that is not directly
innervated. This action can be reproduced artificially by stimulating the
vagus nerve and the motor nerve of a small muscle, such as the thigh or
finger.

The ANS belongs to the autonomic nervous system (ANS). The ANS is part
of an internal organ part of our autonomic nervous system; it is located in
the brain stem and contains neurons that control our bodily functions.
These functions include:

The somatic (somatic) vagal pathway innervates and controls effects on the
heart, lungs, gastrointestinal tract, bladder, ureters, and male genitalia.
The visceral (visceral) vagal pathway innervates and controls effects on
smooth muscles in many body parts.

The two pathways of ANS consist of a cluster of vagus nerve endings

located in the brainstem's medulla oblongata, along with sympathetic
preganglionic neurons that innervate local tissues. These two neuronal
pathways can function independently or in combination to trigger various
autonomic responses.

The somatomotor (somatic) vagal pathway consists of afferent and efferent

neurons that work together to initiate a parasympathetic response. The
somatomotor pathway is used to facilitate a change from a state of alertness
to relaxation; the goal is to reduce the heart rate and decrease blood
pressure. There are two particular types of somatomotor neurons. One type,
termed a vagal afferent neuron (VA), sends signals to the medulla oblongata
and targets both the vagus nerve and sympathetic preganglionic neurons.
Both pathways contain a mixture of static and dynamic fibers, so the
process is not always smooth. For example, cardiac output can be increased
or decreased by the simple act of breathing or coughing.

The efferent (efferent) vagal pathway consists of parasympathetic

preganglionic neurons that control end organs. The efferent pathway can
produce forced expiration in response to multiple afferent inputs to both
pathways (autonomic braking).

The sympathetic preganglionic neurons originate in three areas, the

thoracolumbar trunk, the intermediolateral cell column of the spinal cord,
and a few other areas. The preganglionic sympathetic neurons that control
this pathway are divided into two types. One type termed adrenergic
(adrenergic) neurons sends postsynaptic signals to muscle fibers via alpha-
and beta-adrenergic receptors. The second type, cholinergic (cholinergic)
neurons, use muscarinic acetylcholine receptors to stimulate vagus nerve
receptors. This pathway tends to be blocked by anticholinergics such as
atropine.

The motor (motor) vagal pathway consists of pre- and postganglionic

neurons that act upon skeletal muscle and glandular tissue, as well as
additional effects. The preganglionic neurons originate in the spinal cord.
The postganglionic sympathetic neurons target skeletal muscle, glandular
tissue, heart, blood vessels, and end organs via nicotinic acetylcholine
receptors.

The ANS consists of a cluster of vagus nerve endings located in the

brainstem's medulla oblongata, along with sympathetic preganglionic
neurons that innervate local tissues. These two neuronal pathways can
function independently or in combination to trigger various autonomic
responses.

Therefore, the two-hybrid circuits of ANS include:

1. Somatomotor circuit (or visceromotor circuit):

The vagus nerve endings are located in the medulla oblongata, along with
sympathetic preganglionic neurons that innervate local tissues. These two
neuronal pathways can function independently or in combination to trigger
various autonomic responses. Moreover, the somatomotor circuit (or
visceromotor circuit) consists of afferent and efferent neurons that work
together to initiate a parasympathetic response. The somatomotor pathway
is used to facilitate a change from a state of alertness to relaxation, and the
goal is to reduce the heart rate and decrease blood pressure. In addition,
the vagus nerve fibers are some of the longest known in the human body.
This circuit allows the vagus nerve to play a part in many different organ
systems. Therefore, the somatomotor circuit consists of a variety of different
underlying mechanisms, such as:

a. Triggers of the parasympathetic nervous system:

i. Beginning of activity:

ii. Opioid drugs (tolerance/dependence):

b. The sympathetic nervous system:

i. Sympathetic nerves innervate the aorta and the blood vessels, which can
raise blood pressure; therefore, when a parasympathetic neurotransmitter
is released, it causes vasodilation and lowers blood pressure.
c. The somatomotor circuit controls every organ in your body; however, the
heart is the most important organ in this circuit due to its control by nerves
and hormones that are regulated by this circuit.

2. Visceral circuit:

A cluster of vagus nerve endings located in the medulla oblongata, along

with sympathetic preganglionic neurons that innervate local tissues. The
two neuronal pathways can function independently or in combination to
trigger various autonomic responses. Moreover, this pathway consists of
parasympathetic preganglionic neurons that control end organs. The
efferent path consists of parasympathetic preganglionic neurons that
control end organs.

The ANS consists of a cluster of vagus nerve endings located in the

brainstem's medulla oblongata, along with sympathetic preganglionic
neurons that innervate local tissues. These two neuronal pathways can
function independently or in combination to trigger various autonomic
responses. This circuit controls every organ in your body; however, the
heart is the most important organ in this circuit.

Therefore, the visceral circuit includes:

a. The vagus nerve endings are located in the medulla oblongata, along with
sympathetic preganglionic neurons that innervate local tissues.

The two neuronal pathways can function independently or in combination to

trigger various autonomic responses. Moreover, this pathway consists of
parasympathetic preganglionic neurons that control end organs. Therefore,
this circuit controls all your organs, including the heart, brain, and stomach.

b. The parasympathetic preganglionic neurons that control end organs.

The efferent path consists of preganglionic sympathetic neurons that

innervate the heart, blood vessels, and end organs via nAch receptors.
Moreover, these preganglionic sympathetic neurons originate in three
areas, the thoracolumbar trunk, the intermediolateral cell column of the
spinal cord, and a few other areas; therefore, nerves from the sympathetic
pathway have targets to muscles and glands as well as fiber systems such
as:
i. The parasympathetic preganglionic neurons that control end organs.

ii. The visceral circuit controls all your organs, including the heart, brain,
and stomach.

The visceral circuit controls all your organs, including the heart, brain, and
stomach; however, nerves innervate the GI tract and lymphatic system to
regulate them.

This circuit is related to the gastrointestinal tract because it is activated

whenever you eat, and if the motor circuit is misfiring, you may have
trouble swallowing.

The ANS controls every aspect of your body because it activates all your
organs and sends signals to them to function according to their purpose.
The visceral muscles help us maintain our posture, keep us upright, and eat
and breathe. Moreover, the visceral muscles include:

1. The phrenic nerve:

The vagus nerve controls the parasympathetic function of the diaphragm,

the main muscle involved in breathing. The diaphragm is a large dome-
shaped muscle that separates the thoracic cavity from the abdominal cavity.
It contracts and relaxes to alter the air volume in both cavities and assist
breathing. Therefore, it is composed of two muscles:

2. The esophagus:

i. The visceral nervous system consists of all of your internal organs. In

contrast, the somatomotor nervous system consists of all other organs
except your abdominal organs (such as the heart, lungs, and diaphragm).
However, the ANS is responsible for stimulating or inhibiting the muscles of
the esophagus, which are one group of visceral muscles.

Therefore, the ANS controls your internal organs through three different
pathways that can function independently or in combination to trigger
various autonomic responses. Moreover, the ANS consists of a cluster of
nerve endings in the medulla oblongata and sympathetic preganglionic
neurons that innervate local tissues. The two neuronal pathways can
function independently or in combination to trigger various autonomic
responses. Furthermore, this pathway consists of parasympathetic
preganglionic neurons that control end organs; therefore, these three
neurological circuits are essential for all physiological processes and are
involved in many clinical disorders.

The vagus nerve controls the parasympathetic function of the diaphragm,

the main muscle involved in breathing. The diaphragm is a large dome-
shaped muscle that separates the thoracic cavity from the abdominal cavity.
It contracts and relaxes to alter the air volume in both cavities and assist
breathing.

What is biobehavior?
Behavior is the actions of living beings and their reactions to internal or
external stimuli.

Biobehavior is the study of system-level behavior in an individual. It deals

with how that system integrates its behaviors across all levels, how it
responds to stimuli, and how it can alter itself due to experience.
Biobehociorists are interested in understanding what drives behavior by
examining feedback loops between biology and environment (or between
environment, cognition, and behavior).

Biobehavior may be described in two ways: 1) as a system-level behavior or

2) as the integration of psychological, biological, and social-cultural
variables.

System-level behavior refers to the individual behaviors that comprise an

entire behavioral unit. The term "biobehavior" suggests a focus on macro
behavior—the overall functioning of a living being at all three levels: 1) the
internal physiological, cognitive, and emotional states; 2) the interactions
between internal conditions and external stimuli (such as food availability or
tool use); 3) social interactions with other individuals within the unit (such
as aggression or nurturing).

Biobehavior integrates the individual's biological, cognitive, and social-

cultural processes. At the micro level, this integration involves identifying
the unit's behavioral repertoire (the behaviors it performs at all levels) and
then describing how it responds to environmental stimuli or experiences.
Micro behavior is about finding “the balance between demands of internal
physiological states on the one hand and external stimuli and opportunities
on the other.” The unit's response is a function of its life history, genetics,
developmental history, neurophysiology, psychology, culture, and past
experiences. At the mesos level, individuals within a system communicate
with each other to gain access to resources (such as food or mates). At the
macro level, individuals within a group coordinate their behavior to form
larger groups.

All levels interact. Therefore, the description of micro behavior must also
include Mesos and macro behaviors. The term "biobehavioral system" is
thus a holistic approach to describing a living being at all three levels:
physiological, cognitive, and social-cultural processes.

Biobehavior is complementary to neuroscience, which studies brain function

or neural mechanisms in isolation from the organism or environment (i.e., in
artificial systems). Biobehavior, in contrast, focuses on the integrated
system.

Biobehavior also differs from sociobiology, which focuses on the adaptive

advantage of behavior without regard to an organism's internal processes
or neural mechanisms. In contrast, biobehavior is interested in why
organisms change due to experiences and how they respond to internal and
external stimuli in real time. Biobehavior doesn’t simply explain how
organisms adapt to their environment but also how they alter their
environment due to their behavior.

The term "biobehavior" was coined by O'Donnell (1948). He used it to

describe the relationship between human being and their environment. It
was introduced into a research context by Vittorio Gallese in 2000. Gallese
coined the term "biobehavioral system" to describe a living organism in its
totality, with its psychological, neural, social-cultural, and biological
components. The concept gained popularity among neuroscientists to draw
attention to how internal processes (such as one's beliefs or emotions)
influence behavior. Gallese first used the biobehavioral system (Gallese et
al. 1996). Since its introduction, it has been applied extensively by
neuroscientists and scholars across fields of psychology, sociology,
anthropology, and neuroscience.
In his review of biobehavioral systems, Gallese makes the case that
biobehavioral systems fundamentally differ from traditional reductionist
models of scientific research (such as the physiochemical or genetic model),
which focus exclusively on the external environment, internal physiology, or
neural mechanisms. In contrast, the biobehavioral model of Cacioppo &
Berntson attempts to understand the organism as a “complete situated
activity system” in which “internal processes and the environment
dynamically influence one another through the moment-to-moment
processes of encoding, representing, and producing behavior.”

Biobehavioral narrative analysis is a research methodology designed to

"highlight relational patterning that can illuminate multiple layers of human
experience." It is a collaborative practice that relies on small groups to
build biobehavioral narratives. It integrates qualitative research methods
such as thematic analysis, discourse analysis, and grounded theory with
neuroscience methods such as EEG readings or fMRI scans.

Biobehavioral narrative approaches are useful for identifying complex

patterns of interrelated experiences that traditional quantitative
methodologies may overlook. When we analyze a group of people, we can
uncover how their interpersonal relationships shape one another's behavior
and cognitive processes.

Biobehavior is used in case study research to describe the relationships

between an actor (individual or group) and its environment, including
culture, social class, historical context, and other circumstances.

The biobehavioral approach has been criticized for what is perceived as a

widening gap between the understanding of brain mechanisms and their
behavioral manifestations. Some argue that it is easier to study concrete,
observable behaviors than it is to study relatively intangible cognitive
processes. For example, Antonio Damasio has argued that behavior can be
studied in controlled laboratory conditions. In contrast, an understanding of
decision-making or emotional regulation requires the influence of multiple
individual and environmental factors. Another concern is that biobehavior
relies too heavily on subjective reports from the actor being studied, which
could be affected by memory bias or other reporting errors.
Characteristics of biobehavior:

a. In biobehavior, there are two research directions: from physiological

processes to cognitive and social-cultural processes and from cognitive and
social-cultural to physiological processes.

b. Biobehavioral research aims to study the whole psychological process in

a unified way. When people talk about the brain, they refer to biochemical
processes and physical mechanisms, but they do not talk about how these
biochemical processes influence people's behaviors and thoughts. Suppose
we want to conduct a true study of psychological and cognitive processes.
In that case, we will have to go beyond this kind of analysis and include the
physiological systems.

c. Although there are many studies of physiological processes in isolated

organisms, such as plants or lower animals, few studies include
physiological and ecological (non-physiological effects) components in their
talk about the system being studied.

d. There are also very few studies that focus on the neural mechanisms of a
living organism. Although people have made great advances in
understanding the neural mechanisms at work in lower animals, they have
had less success in explaining how brain function influences higher
organisms, such as humans.

e. Finally, many people like to talk about psychological and behavioral

processes as if these processes were independent of biological systems and
processes. However, virtually all psychological and behavioral processes are
influenced by biological functions (physiological ones). Even cognitive or
social-cultural functions are affected by physical or biochemical processes.
The recognition of the importance of these relationships is particularly
important for research on living organisms, especially human beings.

Biobehavioral systems study human psychological processes in the context

of the mind-body problem, emphasizing the active relationship between
behavior and physiology. The biobehavioral approach is a theoretical
framework that seeks to provide a more comprehensive understanding of
human behavior by accounting for the interactions and interrelations
between the cognitive, neural, social-cultural, and biological levels of
analysis. It examines how these elements dynamically interact with one
another through a process of ongoing feedback loops.

The biobehavioral approach focuses on how psychological processes and

their corresponding substrates (i.e., neural, biochemical, and genetic) are
co-developed throughout an individual’s lifespan (lifespan development).
This approach recognizes the simultaneous influences of biological systems
on human behavior and the complex developmental processes that shape
biological systems over time.

The origins of biobehavioral systems theory stem from the work of

American psychologist Walter Cannon. In the 1920s, Cannon published
"Organization for physiological homeostasis as a basis of behavior," which
argued that all organisms are in a state of physiological disequilibrium with
their environment and that they constantly adjust this equilibrium through
the action process (activity). However, it was not until the post-World War II
cognitive revolution that this theoretical approach became more widely
recognized. In 1950, psychologist William James Dillon published "An
Introduction to the Physiology of Behavior," which became one of the first
texts formalizing Cannon’s behavior theory into a coherent theoretical
framework.

A biobehavioral perspective advocates a shift in focus from decomposing

the mind into different levels (such as cognitive, social, or biological) to
exploring how the mind and body work together to produce behavior.
Vittorio Gallese coined the term to describe a "total system approach" to
psychology and neuroscience. Biobehavioral systems are believed to be
constructed by information originating from neuronal structures that
interact very disorganized with other stimuli, such as internal states,
emotional processes, and cultural contexts.

Effects of activity in the ventral vagus circuit.

Antagonistic effects on heart rate and respiratory frequency (decreasing
both). Activation of the neuroendocrine system, mediating relaxation in
response to sympathetic activation

The Vagus nerve is a major nerve that controls much of the activity in the
ventral vagus circuit. The circuit is responsible for regulating blood
pressure, heart rate, and many other vital processes. Cause of death due to
Vagus nerve damage includes cardiovascular collapse, apnea, and shock.
Treating certain types of epilepsy through surgical removal or destruction
of portions of this pathway has been attempted but with mixed results.

Brainstem projections from the nucleus ambiguus to the hypothalamus are

involved in the neural control of responses to stress and are called
Amygdala modulation by Peripheral Activation (AMPA). Vagus nerve
stimulation inhibits AMPA and causes a decrease in heart rate, suggesting
that efferents from the ventral vagus nerve inhibit sympathetic activity.

Other studies found that electrical stimulation of the vagus nerves

effectively reduces heart rate and blood pressure when administered to
humans implanted with pacemaker electrodes for treating heart failure.

The Vagus Nerve modulates immune cell activity by secreting several

different cytokines. The Vagus Nerve innervates various macrophages, mast
cells, and lymphocytes. The effects are mediated by releasing IL-1, IL-6,
TNFα, and GM-CSF. When administered to mice with experimentally
induced colitis, vagus nerve stimulation promoted M1 activation and
decreased Th17 differentiation without altering normal colonic homeostasis.
Vagus nerve activation also increased the number of circulating CD8+
cytotoxic T cells and NK cells. Other reports suggest that the vagus nerve
can alter the phenotype of DCs by increasing MHC-II and CD40 expression
while decreasing co-stimulatory molecules ICAM-1 & B7.

Increased vagus activity has been associated with cardiovascular disease,

including atherosclerosis and heart failure. The mechanism involves
altering blood flow to the heart by altering baroreflex activity. In one mouse
study, mutant mice homozygous for a disruption in the "Gpr88" gene
significantly reduced atherosclerosis incidence and improved cardiac
function after myocardial infarction. One explanation for the improvement is
that nerve stimulation cannot only alter the normal rhythm of the heart but
also can alter the autonomic tone of the dam.

Stimulation of vagus nerves has been reported to increase the secretion of

endorphins, with an increase in beta-endorphin up to 9 hours after
stimulation. The specific receptors involved are currently being tested.
Vagus nerve tumors are rare but include carcinomas (10%), astrocytomas
(1%), and oligodendrogliomas. Most are located in areas innervated by
white matter and non-motor cranial nerves: olfactory nerves, oculomotor
nerves, facial nerves, and trigeminal nerves. They are treated with surgery
and radiotherapy. The survival rate is surprisingly high; one study found a
recurrence rate of approximately 6%.

Vagus nerve stimulation has been used to relieve neuropathic pain, such as
diabetic neuropathy and postherpetic neuralgia, and to treat depression. A
Cochrane review found that it was effective for neuropathic pain, but there
was insufficient evidence for the effectiveness of vagus nerve stimulation for
depression. In a randomized controlled trial, vagus nerve stimulation was
more effective than placebo for reducing chronic spinal cord injury-induced
neuropathic pain intensity in two of three experimental groups (overall
effect size = 0.25). When more than one technique was used, vagus nerve
stimulation was more effective than a cervical and dorsal rhizotomy.

Vagus nerve stimulation has been used in patients with epilepsy. In one
study, about half of the patients were completely free of fits for five years,
and ten of the sixteen had no fit for four years. In another study, patients
treated with vagus nerve stimulation sustained reduced seizures. They were
over 90% seizure-free after two years, while those not using vagus nerve
stimulation were primarily controlled by valproate or phenytoin.

Vagus nerve stimulation has also been studied for its effect on post-
traumatic stress disorder (PTSD). In one small randomized controlled trial,
a higher dose of vagus nerve stimulation was found to be more effective
than isoflurane anesthesia at reducing PTSD symptoms such as
hyperarousal and flashbacks.

Vagus nerve stimulation has been used for chemotherapy-induced

neuropathy. One double-blind study found that, in patients undergoing
chemotherapy for colorectal cancer, vagus nerve stimulation reduced the
number of hot flashes, improved quality of life, and decreased fatigue in
63% of the patients. A Cochrane review found insufficient evidence
supporting vagus nerve stimulation as a replacement for or adjunct to
conventional methods for treating chemotherapy-induced peripheral
sensory neuropathy.
Vagus nerve stimulation is used as a muscle relaxant. This is often achieved
through a transcutaneous method by stimulating the vagus nerve through
electrodes implanted at a distant site called an activator station.

Therefore, the effects of activity in the ventral vagus circuit include:

a. The parasympathetic thrills originate from the nucleus ambiguous, pass

via the Wallerian tract, and terminate in the superior cervical ganglion,
where the fibers cross to form the recurrent laryngeal nerve.

b. Stimulation of the vagus increases glutamate secretion by inhibiting

kainate-type substances with vagotomy or bilateral nucleus ambiguous
lesions.

c. With continuous stimulation, there is an increase in excitatory

transmission at both distal and proximal levels of thalamocortical synapses
and an overall excitatory effect on the cerebral cortex (cf - The vagus nerve
modulates cortical activity)

d. The interaction of both phasic and tonic components of the vagal

afferents with both phasic and tonic components of the cortical afferents
modulates cortical activity

e. The sustained activation of cortical neurons damages the synaptic

connections.

f. Cortical Hyper-reactivity: (for pain, fatigue, motor disturbances,

depression)

Vagus nerve stimulation has also been used to stimulate the respiratory
muscles. In one randomized trial, 20 patients were treated with high-
frequency vagus nerve stimulation for six weeks to alleviate their chronic
obstructive pulmonary disease (COPD). Twenty-five percent had a decrease
in airflow at rest, and 50% had an improvement in forced expiratory volume
in one second (FEV1).

g. Vagus nerve stimulation has been used to stimulate the respiratory

muscles. In one randomized controlled trial, 20 patients were treated with
high-frequency vagus nerve stimulation for six weeks to alleviate their
chronic obstructive pulmonary disease (COPD). Twenty-five percent had a
decrease in airflow at rest, and 50% had an improvement in forced
expiratory volume in one second (FEV1).

h. It has been observed that the onset of action is within a few days and
tends to stabilize after two weeks.

i. In supraventricular tachycardia (SVT) cases, vagus nerve stimulation is

beneficial in converting the heart rhythm from SVT to normal sinus rhythm.

j. It has been observed that vagus nerve stimulation can improve cardiac
output, mean arterial pressure, and stroke volume in patients suffering from
myocardial infarction by increasing the vagal tone.

k. Vagus nerve stimulation is also known to enhance food intake by

stimulating gastric secretion, motility, and secretion of pancreatic juices
resulting in better digestion and absorption of nutrients

In a small study, vagus nerve stimulation improved the ability of patients

with spinal cord injury to tolerate various stimuli, including hypoxia and
hypercapnia.

Post-traumatic stress disorder (PTSD) has been found to be associated with

hyperactivity in the amygdala, a brain region involved in fear learning and
memory, and decreased activity in the ventromedial prefrontal cortex
associated with extinction learning. Vagus nerve stimulation has been found
to decrease the activity of the amygdala and improve extinction learning of
PTSD symptoms.

At least two patients with Tourette syndrome have been treated with vagus
nerve stimulation. Both were in their fifties and had the most severe form of
the disease; both showed improvement in symptoms after treatment.
Neither had responded to any other treatment, but both showed significant
improvement only when vagus nerve stimulation was used in addition to
anti-psychotically drugs.

Diabetes-associated neuropathy may be successfully treated by a

pacemaker-like device implanted in the chest that sends continuous
electrical pulses to the left vagal nerve. Wearable devices, such as hearing
aids, have been designed to stimulate the vagus nerve. Various vagus nerve
stimulators are commercially available from several companies that offer
these devices for therapeutic and diagnostic applications.

Effects of activity in the dorsal vagus circuit.

The dorsal vagus nerve is the longest cranial nerve, which sends branches
to the stomach, lungs, and other viscera. In humans, it is sometimes called
the pneumogastric nerve.

The dorsal vagus nerve is comprised of afferent fibers that carry sensory
information and efferent fibers that relay motor commands to the muscles of
the stomach, gallbladder, and intestines.

The dorsal vagus nerve plays an important role in regulating digestion.

When stimulated by a gastrointestinal input (e.g., intestinal distention), it
causes smooth muscle contraction in those organs to enhance their
peristalsis and expelling functions.

The efferent motor commands in the dorsal vagus nerve reach the viscera
after they cross the spinal cord via synapses in the paragigantocellular
reticular formation. Those fibers are part of a reflex arc that involves
afferent and efferent fibers from the nodose ganglion to relay sensory
information about blood pressure, respiration, and swallowing.

The nervous connections between viscera and brain function in areas like
satiety and appetite. Vagal afferents send signals to the area postrema,
located at the base of the fourth ventricle in the brain. The area postrema is
an important brain structure because it is rich in neurons that sense
changes in blood composition, such as pH or glucose levels, and relay that
information so the brain can respond. For example, those neurons send
signals to the hypothalamus when they sense a change in glucose levels to
elicit an appropriate response—either to get food or store energy by
decreasing metabolism.

Activity in the dorsal vagus circuit can inhibit the sensation of nausea when
stimulated through the area postrema after peripheral activation. Activity in
this circuit can also suppress food intake by modulating centers responsible
for hunger and satiety and affect autonomic control over heart rate,
bronchial reactivity, and airway resistance. Vagal afferents from the dorsal
vagus nerve send signals to the nucleus tractus solitarii (NTS) in the
brainstem, a connection point of neural pathways that control
cardiovascular, respiratory, and gastrointestinal functions. The dorsal vagus
first synapses on NTS neurons before it sends signals to areas that control
food intake and satiety.

The activity in the dorsal vagus circuit can also affect respiratory control
during sleep-breathing disorders such as chronic obstructive pulmonary
disease (COPD). Patients with COPD experience difficulty breathing during
sleep because they have shallow breathing and because they experience
micro-awakenings during the night. Those micro-awakenings are associated
with arousals from sleep and periods of hyperventilation followed by apnea.
The dorsal vagus nerve is part of the pathway that relays neural signals to
control respiratory function, such as snoring and breathing during sleep.

In an experiment, the activity in the dorsal vagus nerve was stimulated in

healthy subjects to test its effects on breathing during sleep. In response,
the autonomic nervous system sends efferent commands to increase airway
resistance, slow down breathing rate, and prolong expiration time. Those
changes in breathing resulted in decreased apnea episodes and better blood
oxygenation. Those changes occurred without stimulating other reflex
pathways (e.g., via carotid body stimulation). The activation of the dorsal
vagus nerve made healthy subjects respire at a slower rate during sleep and
did not affect breathing during wakefulness.

The dorsal vagus nerve is important in keeping people alert and in good
health. People who lack enough activity in the dorsal vagus circuit can
experience symptoms such as pain and depression because they cannot
respond to those signals sent from peripheral organs, resulting in
maladaptive eating patterns that contribute to weight gain by increasing
appetite.

The dorsal vagus nerve is an important target for treating several

conditions, including gastrointestinal, heart, eating, urinary, and movement
disorders.

There are a variety of different disorders that can involve the dorsal vagus
nerve. Some of them include:
a. Disorders related to the dorsal vagus nerve

d. Disorders that can cause damage to the dorsal vagus nerve

e. Diseases affect areas in which the dorsal vagus nerve plays a role

g. Conditions of unknown cause

h. Other conditions, where more research and answers are needed

i. Bibliography

Several clinical trials are being performed to treat dorsal vagus nerve
conditions. One of them is to test if electrical stimulation of the dorsal vagus
nerve in patients with severe depression can reduce depressive symptoms
and improve mood. Another one is to use electrical stimulation of the dorsal
vagus nerve with a gastric pacemaker to treat obesity. Another clinical trial
uses an implanted device that stimulates dorsal root ganglion cells to treat
pain from diabetic neuropathy.

Some of those disorders can be treated by stimulating activity in the dorsal

vagus nerve or by directly implanting electrodes on that nerve. The
electrical stimulation is done to reverse the symptoms of the disorder. For
example, intestinal paralysis caused by C. difficile infections can be
reversed when patients are given electrical stimulation to the area
postrema to stimulate peristalsis and relieve constipation. When a serious
illness like cancer causes intestinal paralysis, or when patients are under
stress, electrical stimulation to the area postrema can be sufficient.

The dorsal vagus nerve can also be used as an alternative method of

treating some pains from diabetic neuropathy. In patients with diabetic
neuropathy, nerves in the peripheral nervous system that originally
stimulated muscles so that muscles contract and relax are damaged. That
type of nerve damage results in pain and weakness, resulting in
compression of nerves in the neck or other areas. The dorsal vagus nerve
normally supplies those nerves on the neck with signals that tell them to
contract muscles so that patients experience relief from pain. To treat pain
and weakness caused by diabetic neuropathy, electrodes can be implanted
on the dorsal vagus nerve at the base of the neck or in other areas to
provide signals from a small generator.
When patients are given electrical stimulation to their dorsal vagus nerve
over time, they become more sensitive to that electrical stimulation,
resulting in reduced symptoms caused by the dysfunction of other organs.
For example, patients with irritable bowel syndrome who are given
electrical stimulation over six months’ notice improved digestive function
after treatment.

When it is unable to properly send signals related to swallowing and eating

food, patients can experience dysphagia—difficulty swallowing that could
result in aspiration pneumonia and death.

The dorsal vagus nerve that innervates the heart has a dual function. When
activated, it slows down the heart's beating by inhibiting the firing of
neurons that control heart rate (called pacemaker cells). On the other hand,
it increases the force of contraction by controlling muscarinic receptors in
cardiomyocytes. It also functions as a third-order sensory nerve and
innervates the peripheral nervous system, which controls bladder and bowel
activity. The tract of nerves central to the control of cardiac rhythm and
autonomic nervous system activity is known as the vagus nerve. This has led
to its being called both the parasympathetic and sympathetic nerves. People
with damage to their dorsal vagus nerve usually have little or no control
over their heart rate.

Many structures within the spinal cord are interconnected with one another
through a very wide network of nerve fibers, almost like an intricate net
that spans from above down to below. The dorsal vagus nerve is one of the
most prominent connections that extend from the brain to the spinal cord.
The connection between these nerves and the rest of the nervous system is
called a nerve root.

The dorsal vagus nerve has many branches and endings, some of which are
important for it to function in its normal purpose. There are two main
branches, called cranial and caudal median nerves. The median cranial
nerve runs from the brain stem as a branch of the fifth cranial nerve
(trigeminal). It then runs along with other nerves from the brain stem to
reach its target on the back of the head just below the ear lobe.
The other main two branches of the dorsal vagus nerve are the caudal
median nerve and the caudal vagus nerve. The caudal median nerve is also
called the vagic or cranial vagus nerve, which is located just above the
thyroid gland and continues to reach its target on a small tissue on the back
of the brain stem. It then continues towards a large portion of the brain
known as pons and medulla oblongata.

The functions of these two branches are different in contributing to the

overall action of the dorsal vagus nerve.

Therefore, the activity in the dorsal vagus circuit includes:

a. Decreased heart rate (pacemaker cells)

b. Increased force of contraction

c. Decreased force of relaxation (muscarinic receptors)

d. Increased parasympathetic tone to heart.

e. Decreased sympathetic tone to heart

f. Decreased intestinal motility (kidneys, bladder, and intestines)

g. Decreased secretion of gastrointestinal hormones related to motility and

absorption

h. Increased secretion of pancreatic enzymes by pancreas

i. Increased secretion of gastric acid by stomach

j. Increased secretion of biliary acids by liver

k. Decreased secretions of hormones from adrenal medulla, pancreas, and

thyroid gland

l. Increased secretions of gastrointestinal hormones related to digestion

m. Stimulation of the dorsal ventricular dilatation in the brainstem, which

results in decreased blood pressure (baroreceptor activity)

n. Stimulation of carotid body activity—increased breathing rate (reduces

CO2 levels) and increased oxygenation of blood (reduces acidosis).
 Somatopsychological problems.
This is when you feel a headache, itches, your neck hurts, or pain at the
back of your head. People with somatopsychological problems experience
their bodies as a source of distress.

Somatophobia's effects on social life can make it very difficult for those who
suffer from this disorder. The solution to overcoming this disorder will
require additional time and energy that interfere with daily activities.

The vagus nerve entrainment may help alleviate somatopsychological

symptoms in people with vagus nerve entrainment problems due to its
relaxing health benefits. Still, it should not be relied upon on its own.

Since the vagus nerve is a calming nerve, it is a useful tool for pain
management. The vagus nerve is also related to digestion since it helps
move food along the gastrointestinal tract.

People with somatopsychological problems, on average, have difficulties in

starting and maintaining conversations. However, people with vagus nerve
entrainment may find it easier to communicate due to its ability to relax the
body through tension.

Since the vagus nerve plays a role in warm and cold systems, it can be an
important tool in certain medical applications, such as researching
temperature control concerning potentially life-threatening diseases.

The vagus nerve is related to the solar plexus, which plays an important role
in controlling the body's temperature. This may be related to sensitivity to
cold and hot temperatures.

In addition, the vagus nerve also plays a role in relaxing the body. This can
help people with somatopsychological symptoms since tension is common in
somatopsychological disorders.

Situations requiring patience and focus on mental tasks are also common
among people with somatopsychological problems. The vagus nerve
entrainment may help relieve stress due to the muscle relaxation it entails.

Another way that vagus nerve entrainment may be beneficial to people with
somatopsychological problems is when it comes to dealing with physical
pain. The vagus nerve helps process painful stimuli in the body by sending
signals processed by the brain.

Vagus nerve entrainment may also improve a person's focus on physical

activities due to its ability to relax muscles and reduce stress. In addition, it
also improves sensation and movement coordination when performing
certain tasks.

Therefore, people who have difficulty focusing on certain tasks may find it
easier to use vagus nerve entrainment as a relaxation technique before
performing tasks requiring focus.

The vagus nerve plays a role in managing stress because it helps regulate
the amount of oxygen that reaches the brain. This can be useful for people
with an overactive nervous system.

Vagus nerve entrainment can be used to improve blood and bone

circulation, which are related to improving sleep quality. This is important
since excessive sleepiness can cause somatopsychological problems.

Vagus nerve entrainment can also benefit people suffering from diabetes
since it improves blood glucose monitoring and body temperature
regulation.

In people with diabetes, the vagus nerve is often damaged. This can be
alleviated by vagus nerve stimulation. Vagus nerve entrainment can help
maintain the vagus nerve's function so that it is not further damaged if it
has not been affected by damage before.

Vagus nerve entrainment may also be effective in those who experience

pain during nervous stimulation due to its calming benefits. This can be
especially helpful for reducing the severity of migraines and tension
headaches since these are common somatopsychological symptoms
affecting many people.

Therefore somatopsychological problems include:

a. Discomfort in your body

Discomfort in your body can be in the form of pain, a common symptom in

various diseases such as arthritis and other inflammatory diseases. Pain is
often treated with over-the-counter or prescription medicines since it may
be caused by a medical condition such as muscle strain or injury that needs
further attention from the doctor.

Its characteristics include:

• recurrent, widespread pain

• diffuse, intermittent pain

• mild to moderate intensity of pain

• sensitivity to cold and heat

This discomfort can be in the form of itching or any other type of physical
discomfort. It is often found on the surface of your skin, which varies from
person to person. This can depend on how sensitive your skin is, but it is
generally believed that people with dry skin suffer from this more than
those with oily skin. These types differ in how the treatment is provided
using different products, including creams and lotions that help relieve the
symptoms associated with discomfort in your body.

b. Feeling dizzy

Feeling dizzy can be caused by factors such as a change in altitude,

standing up for long periods without moving, and changes in atmospheric
pressure due to weather changes. Dizziness can also be caused by several
medical conditions that require immediate attention from a healthcare
provider such as heart disease, low blood pressure, poor nutrition,
pregnancy, and vertigo.

Its characteristics include:

• feeling unsteady on your feet

• seeing things spinning around you

• feeling that the world is spinning around you

• difficulty focusing your attention on something when standing still or lying

down
It is characterized by a feeling that you are moving even though you are not
or that objects in your surroundings move, even if you are standing still.
Aside from this, it can also result in nausea and vomiting. This can happen
after getting out of bed or turning suddenly due to motion sickness, motion-
sickness-inducing stimuli such as the following seasickness, watching
vehicle movement while riding in a car or boat, and reading or watching
television while traveling.

c. Headaches

Since headache is a common symptom of several diseases, it can be treated

with prescription medicines such as pain relievers. However, if the cause of
the pain is in your nervous system, then vagus nerve entrainment may be
beneficial.

Its characteristics include:

• usually felt in one part of your head

• usually feels like "a band around your head" that gets worse with any
movement or activity. This can cause a feeling of pressure and sometimes
may make you feel nauseous. It can be associated with both tension and
migraine headaches.

• intensity of pain is low to moderate

• onset is gradual

• frequency of headaches increases with age.

According to the website mentioned above, migraines are characterized by

a rapid, pounding pain that covers one side of the head and sometimes
extends down your neck and into your back, usually accompanied by severe
visual disturbances. They can also be accompanied by temporary loss of
vision and sensitivity to light. Onset can occur minutes to days before the
headache, lasting a few hours after its occurrence. A migraine headache is
associated with 5-14 days of attack frequency per month unless stated on
this website's page about migraines.

d. Numbness
Numbness is a symptom of peripheral vascular disease, carpal tunnel
syndrome, and diabetes. It is characterized by tingling, numbness, or loss of
feeling in the hands and feet. This can happen when walking and standing
up too quickly. Numbness can also be caused by changes in atmospheric
pressure due to weather changes or altitude changes.

Its characteristics include:

• tingling or numbness in your hands and feet

• can sometimes be accompanied by weakness or muscle spasms

• usually feels as if the circulation is impaired.

e. Pain with movement

Pain without movement is a common symptom caused by arthritis and

fractures that may require medical attention from a healthcare provider.
Pain with movement may affect someone's ability to move effectively since it
can cause stiffness in muscles and joints when moving them.

Its characteristics include:

• pain in your joints or muscles

• pain with exertion or movement of your joints and muscles

• the pain worsens with movement but rarely goes away on its own.

f. Loss of appetite, weight loss, and fatigue

Loss of appetite can be caused by several diseases, such as diabetes,

gastrointestinal disorders, cancer, pancreatic cancer, and hypothyroidism.
These may also occur after a traumatic event such as surgery or other types
of injury. Loss of appetite is also one of the most common symptoms
experienced by patients suffering from depression, which is characterized
by long-term sadness or depression that can have causes that are not
physical, such as anger and frustration.

Its characteristics include:

• lack of appetite and poor appetite

• often occurs when a person is in bed or even on the couch watching
television, causing you to feel guilty about giving up your favorite food and
unable to bring yourself to eat it.

• may or may not cause weight loss

Stress and sympathetic nervous system.

The sympathetic nervous system is often called the "fight or flight"
response. When something triggers, the adrenal gland releases a stress
reaction from the brain, adrenaline, and cortisol. This hormone enables you
to respond quickly and appropriately when faced with a challenge or
danger. One way that your body is affected by this reaction is through your
stomach and intestines — you may notice that hunger disappears, bowel
movements slow down, food moves slower through your stomach, or bolts of
pain shoot down your esophagus.

Some people can't make cortisol in response to stress and may lack the
ability to respond with a fast-acting fight or flight response that would
enable them to survive. These people may experience chronic stress or even
depression. The body can adapt to chronic stress, but this adaptation may
be unhealthy. Some symptoms of stress are reduced appetite, cold hands
and feet, fatigue, difficulty sleeping, and tendencies to overeat or eat foods
high in sugar.

Stress is often worsened by social isolation, which makes it difficult for you
to deal with negative emotions and hard to face the things that are going on
in your life. You may find that you go through a period of stress each day
when faced with something difficult, like dealing with a bully or being
bullied yourself. If you live alone and are isolated from friends, family, and
other people, depression can result from stress.

Feeling stressed is natural; it's part of life. But when stress is chronic or
serious, it can lead to health problems. A chronic overreaction to everyday
stressors — a pattern of intense or persistent worry, anxiety, and tension
that might not seem like something you have control over — is the most
common form of mental illness in the United States. Over one-third of adults
in this country report having symptoms of clinical depression within the
past year.
In addition to impacting our health, chronic stress can also take a financial
toll on families. People who report chronic stress are more likely to miss
work and have lower salaries. They are also more likely to divorce or
become separated from a spouse and have fewer financial resources. If you
live alone, you may use up all of your "social capital," which can lead to
social isolation and stress.

Stress can affect many aspects of health and well-being, including chronic
pain, heart disease, high blood pressure, high cholesterol, anxiety,
depression, breathing problems, sleep disorders, gastrointestinal
complaints (such as nausea), migraines, immune system problems, lack of
concentration, weight issues, poor memory. Cortisol also makes people
more prone to other chronic diseases.

When you're under stress, you may find that you're tired all the time and
aren't able to fall asleep at night. You may have trouble concentrating,
especially if you are under mental or physical stress. If you suffer from
chronic pain, the adrenal glands may be at work making chemicals that
make pain worse instead of better. This is a vicious cycle of thought and
feeling, leading to an adrenal gland reaction that leads to symptoms in the
body that worsen the pain.

The stress response in the body is primarily mediated by the sympathetic

nervous system, which stimulates the heart to beat faster and raises blood
pressure. The body also releases norepinephrine, a chemical that mobilizes
the brain and body for "fight or flight" activity. Cortisol is released from the
adrenal cortex in response to stress, increasing glucose levels to provide
energy for the muscles so they can be prepared for action. However, if the
muscles are not engaged in action, they will instead put the glucose into fat
cells — thus contributing to weight gain. On top of that, cortisol also
increases appetite and decreases metabolism.

Cortisol has other effects as well. It sensitizes pain receptors and promotes
inflammation. It contributes to feelings of apathy or depression. It
suppresses immune function and growth processes, leading to an increased
risk for illness or cancer. It may even cause a decline in the thinking skills
you need for survival.
This stress response must have a "shut-off valve" because if it were to
continue unchecked, it would destroy your health! When you are fleeing
from a predator, for example, cortisol levels rise but fall again when there is
no longer any danger.

On the other hand, cortisol levels don't always fall back down when they
should. Thus you may find yourself experiencing a constant state of fight or
flight. If you are always looking for danger, your body may be unable to
completely shut down that adrenaline reaction.

If you can't fall asleep at night or wake up in the morning with a feeling of
dread, that's a message from your body. It tells you something is wrong and
needs to be dealt with. If problems during the day cause the same reaction,
these messages can pile up without resolution and make it harder for your
body to return to a state of equilibrium and rest. Chronic insomnia can turn
into a vicious cycle of insomnia, leading to more stress, less sleep, and even
more stress.

The stress response is not necessarily negative. It can be good when it

alerts you to a potential threat or danger. However, if you are always in
fight or flight mode, this can lead to problems. The battle-ready state is
more likely to lead to a lack of sleep, chronic health problems, and weight
gain than survival.

What would happen if you turned off your stress response? Well, some
people often become very quiet after they stop stressing over a situation.
You may even see them looking in the mirror and saying things like: "I've
given up!" or "There's nothing I can do!"

Paradoxically, this is more stressful than dealing with the source of stress.
It is one thing to deal with a bully in person and another to feel helpless.
Some people go into denial and say that the bullying doesn't bother them,
or they make excuses for the bully. These reactions are often worse than the
stress response itself because they add to the load on our bodies and keep
us from doing something about it.

When you live in an environment where bullying is routine, the stress

response can be very useful. It may not allow you to handle the situation by
yourself, but it will have had a positive effect — allowing you to do
something about it.

The most important thing is to avoid being constantly angry or overtired. If

you have made a serious effort, given up enough time, and couldn't get
away from your bully or situation, this will come naturally as long as you
give your body what it needs — rest.

If you're one of those who has a hard time getting over stressful situations,
it may be time for you to take charge! The first step is learning how your
body responds under stress. You'll find out what isn't healthy for you and
what you need to do to fix it. You'll also learn the difference between stress
and emotions.

Relationship between stress and sympathetic nervous system:

a. If a person is exposed to stress, he/she produces more adrenaline.

b. Adrenaline is released from the adrenal medulla.

c. Adrenaline causes the sympathetic nervous system to be stimulated.

d. Sympathetic nervous system stimulates heartbeat and raises blood

pressure; Simultaneously, it stimulates the part of the adrenal cortex, which
releases cortisol into the bloodstream, reaching its peak 20 minutes after
release.

Therefore, if you are experiencing high levels of stress day in and day out,
your adrenal glands are probably overworked and exhausted; hence your
immune system cannot work at its best. As a result, you will be prone to
infections and other health problems.

e. You will also be likely to catch up with a cold easily.

To sum it up, if a person is experiencing high levels of stress and does not
know how to get rid of it, they should talk to the doctor and find out how to
reduce their stress. They should also talk to an expert who can help them
understand how to best deal with their stress, helping them to release all
that pressure. This way, they will enjoy a healthy life and stay as fit as
possible.
 The fight-- or fly reaction.
Fight or fly reaction is a term used when referring to the reaction of the
vagus nerve to danger and other stimuli. The vagus nerve is a large cranial
nerve that starts in the medulla oblongata of the brain stem and descends
through the neck, chest, abdomen, diaphragm, spleen, and pancreas. Its
role includes aiding in heart rate control via modulation of parasympathetic
activity from thoracic spinal cord circuits (the "cardiac" vagus) as well as
maintaining intestinal tone via stimulation of preganglionic sympathetic
fibers from enteric ganglia (the "enteric" vagal).

The vagus nerve works by inhibiting the over-action of other cranial nerves.
It slows down the heart rate and smooths muscles when the carotid sinus
nerve is stimulated (i.e., carotid pressure increases). Likewise, it slows
down breathing when sacral parasympathetic fibers are activated (i.e.,
sacral pressure increases). The vagus nerve also inhibits other organs,
including stomach acid secretion, to increase blood flow to the gut in a
reflex called vomiting in an attempt to compress the intestines and promote
blood flow away from them in a protective mechanism called emesis (from
Latin emere "to eat," and ceteris paribus "all other things being equal").
Hence, the fight or flight reaction involves a sudden and dramatic increase
in heart rate and blood pressure due to over-activation of the vagus nerve to
stimulate the heart and inhibit gastrointestinal activity (inhibit peristalsis).

The vagus nerve response is a stress response we have to varying degrees.

It's sometimes called fight or flight. When stressed, the hypothalamus
releases corticotropin-releasing hormone (CRH) into the hypophyseal portal
system, which goes directly to the anterior lobe of the pituitary, which then
releases adrenocorticotropic hormone (ACTH) into the bloodstream, which
causes our adrenal glands to secrete cortisol and other glucocorticoid
hormones. This "stress response" activates our sympathetic nervous system,
or "fight or flight" mode.

When this happens, we may develop an ulcer in our digestive tract that can
become very serious. One of the factors that can affect the development and
healing of an ulcer is our behavior. Our vagus nerve plays a very important
role in this. Under stress, our sympathetic nervous system, fueled
exclusively by acetylcholine and norepinephrine, is activated.
Norepinephrine inhibits the firing rate of vagal parasympathetic pre-
ganglionic fibers; this leads to decreased parasympathetic tone that
manifests as arrhythmia (irregular heartbeats) and a reduced heart rate.
Norepinephrine also enhances the secretion of adrenocorticotropic
hormone (ACTH) via stimulation of the hypothalamic corticotropin-releasing
hormone (CRH) receptors. The increase in ACTH increases the secretion of
glucocorticoid hormones, especially cortisol. This leads to a reduction in
glucose levels and protein breakdown that is used to form amino acids and
fatty acids, which are used as fuel for muscles during exertion; this
preserves glucose for use by the brain. Cortisol also causes a decrease in
blood flow to the digestive tract (by decreasing gut motility), slowing down
digestion and nutrient absorption. All these effects aim to provide fuel and
energy to the muscles so we can escape a predator.

There's some controversy about how cortisol acts on the gut. One study
suggests that cortisol has two effects: it increases mucosal permeability
(blood flow to the gut), which leads to inflammation, and it inhibits gastric
secretion (reduced acid secretion), which can lead to ulcer formation.
Another study found that cortisol did not affect mucosal permeability or
gastric acid output; instead, it decreased blood flow by increasing vascular
resistance in the hepatic portal system, which slows down food uptake from
the gut into circulation.

Characteristics of fight or flight reaction are:

a. Increased heart rate (tachycardia)

This is due to the sympathetic nervous system driving up heart rate and
blood pressure to enhance our ability to run away. Heart rate is increased
because the vagus nerve is inhibited by norepinephrine (a neurotransmitter
derived from dopamine produced in the locus coeruleus) which decreases
the parasympathetic tone of the heart. A reduction in parasympathetic tone
leads to an increase in heart rate.

b. Decreased gut motility

This also occurs due to sympathetic activation; sympathetic stimulation of

adrenergic receptors on intestinal musculature leads to decreased
gastrointestinal motility and delays stomach emptying, inhibiting gastric
acid secretion and reducing blood flow within the gut wall.

c. Increased blood pressure (tachycardia)

The increase in sympathetic stimulation leads to an increase in arterial

pressure by constricting the peripheral veins and arteries.

d. Decreased ventilation

This occurs by inhibition of inspiratory flow caused by

hyperventilation. Lastly, biofeedback techniques can help you control your
VN response.

One way to do this is through biofeedback training; during this process,

breathing is monitored, and the participant is told when they are breathing
too fast or too deeply, which will trigger a response they can consciously
control.

Other ways to help control our vagus nerve response include eating more
fiber, not eating spicy foods, not eating carbonated drinks and caffeine,
getting regular exercise (slow cardio), self-hypnosis, etc...

e. Increased vagus nerve activity

This occurs when we are in the early stages of an ulcer with inflammation
(nodular phase) and necrosis (necrotic tissue). During this time, your vagus
nerve will be stimulated at a higher than normal rate causing diarrhea,
heartburn, burping, etc... Because this phase is not fully differentiated,
there is still some heart and gut motility so that it can be both excreted and
recirculated. Once your ulcer is healed, it will decrease to a normal level
because the inflammation has been suppressed along with any subsequent
damage to the vagal nerves.

f. Decreased vagus nerve activity

This occurs when your ulcer has healed and is completely differentiated. In
this case, no high inflammation or necrosis is causing the vagus nerve to be
stimulated to return to normal levels.

The best way to stay healthy and heal your ulcers is to keep your stress
levels down and get a restful sleep every night.
These characteristics have been found to affect the development of ulcers.
Ulcers are caused by inflammation and increased acid secretion in the
lining of the stomach (lower esophageal sphincter), damage to the lining of
the stomach or esophagus, or both (called gastric erosions). It is well known
that our digestive system functions less efficiently when we are under
stress. We experience a reduced ability to digest food, and our stomach
secretes less acid. It also has been found that when we are under stressful
conditions, the blood flow to the gastrointestinal tract decreases, which
contributes to an increase in inflammation, making it more difficult for the
body to heal itself from a potentially serious condition. Thus, it is believed
that stress can lead to stomach ulcers and make them worse once they
develop.

Therefore, it is believed that stress can lead to ulcers and cause them to
develop. It is hypothesized that the stress induced by an illness, a divorce,
or a death in the family, for example, can lead to gastritis (inflammation of
the stomach), which in turn leads to ulcers. According to this hypothesis:

- Ulcers are genetic-related diseases; they are transmitted from generation

to generation via genes.

- Stress causes gastritis and the development of ulcers; hence stress causes
ulcers.

Other factors could contribute to gastric ulcer formation, like personality

traits and environment.

- Stress can cause gastritis, which in turn can lead to ulcers.

- Stress is responsible for the formation of gastric ulcers.

However, contrary to the hypothesis that stress causes ulcers, stress does
not cause the disease; it only worsens the existing disease or prevents it
from healing. People who believe that stress causes their gastric ulcers may
undergo psychotherapy and medications in modern medicine.
Psychotherapy aims to resolve psychological problems such as anxiety and
depression by relaxing the person involved so they don't feel so stressed
out. Some medications, such as antidepressants and anxiolytics (anti-
anxiety medicines), reduce stress levels.
 The polyvagal theory’s healing power.
The polyvagal theory is a scientific model of the autonomic nervous system
introduced by Stephen Porges. It views the vagus nerve as the primary
nerve of calming rather than our old-fashioned explanation of adrenaline. It
has many similarities to the mammalian fight-or-flight reflex.

Synchronicity is the coherence of meaning between seemingly unrelated

events and suggests a meaningful order behind it. In this way, synchronicity
can be viewed as a form of physical correspondence concerning time, space,
and causality. One very specific kind of synchronicity involves the
perception by an organism or human being that one event is relevant to
another event that seems entirely disconnected from it by context and time.
This perception can be explained as coming about through nonlocal
influences or a kind of collective unconscious communication or human
instinct or learned behavior.

This theory's healing power is seen in the medical field. It explains how the
brain keeps us from putting on weight and can help us with its healing
powers. Staying connected to our emotional center, we can forgive
ourselves, feel less pain, gain better perspectives, and be closer to peace.
Some books cover how to use Nature's system of healing methods to solve
problems that may arise.

The polyvagal theory, inspired by the work of Austrian neuroscientist

Stephen Porges, is a new view of the autonomic nervous system that
proposes two distinct nervous systems in humans—the sympathetic and
parasympathetic. Traditionally, these were viewed as two independent
systems and have been studied separately. However, the polyvagal theory
posits that they can be viewed as two aspects of the same system, with a full
spectrum of activation and deactivation between them. The model was
developed over decades, starting in the 1980s, by Porges and his
colleagues, who studied it as an alternative to traditional views. Early
versions of the theory posited that there was a continuum between these
two systems. In later versions of the theory, the two systems have been
viewed as more distinct from each other and joined by a bridging system.
The polyvagal theory is based on recent neurophysiological discoveries
concerning two phylogenetically older autonomic nervous system
components, reptilian brain centers associated with defensive reactions and
mammalian brain centers associated with social engagement behaviors. The
theory proposes that the autonomic nervous system evolved through two
major stages (see below). According to Stephen Porges, the polyvagal
theory is an integrative theory of social engagement and the fight and flight
responses because it proposes that these two systems — which have
traditionally been described as separate for each individual — are instead
one single phylogenetic system. The notion that mammals have a variety of
strategies to deal with threats is not new; however, what is new about this
theory is that it proposes that mammals also have a full spectrum of
strategies to deal with safety and social engagement.

The Polyvagal Theory, according to Porges (2007), is a relatively recent

theory of the autonomic nervous system. “polyvagal” means multiple vagus
(i.e., vagus nerve) fibers. However, the Neuro-physiology of Polyvagal
Theory proposes that the two types of the vagus nerve are not different
entities but instead are components of a single phylogenetically older
system that evolved in two major stages: 1) primitive reptilian brain centers
that emerged before mammals and 2) mammalian brain centers that
emerged after mammals. The theory proposes that mammalian vagal
structures are more social because they evolved later to help primates and
mammals survive challenges. The basic idea behind the theory is that there
is a spectrum of neural circuits ranging from primitive to most evolved. The
“newest” circuit evolved first, followed by an intermediate circuit, followed
by the “oldest” or most primitive circuit in mammals and other vertebrates.

The polyvagal theory also draws on a wide range of cross-disciplinary

research in fields such as neurophysiology, anatomy, linguistics, ethology,
communication sciences, audiology, and comparative psychology. It is in
many respects an integrative theory because it proposes that the autonomic
nervous system can be understood by looking at multiple levels of
functioning: the organ level (e.g., heart rate), the visceral level (e.g.,
visceral organs such as intestines and lungs), the level of structures (e.g.,
vagus nerve), the behavioral level and finally at the state that integrates
these coping strategies into a coherent whole (e.g., variations in state
regulation such as distress or social engagement).

The benefits of polyvagal theory’s healing power are:

a. Social Support

Social support is a way to destress the body and mind. We need social
support in our everyday life to prevent stress and increase well-being. It is
important for healing because it helps keep us healthy and reduces stress
through regular exercise, meditation, yoga, or sports.

b. Emotional Balance

We can do many things to keep our emotions balanced, such as going for a
walk-in nature, hiking in the mountains, taking deep breaths, and calming
down. The benefits of emotional balance are: feeling more confident and
calmer, helping you to overcome problems or conflicts with others or with
yourself. Emotional balance improves self-esteem, therefore, keeping us
happy and healthy

c. Self-compassion

Being kind to yourself through eating healthy, exercising, and other good
habits helps us to feel good about ourselves. Self-compassion gives us the
courage to change bad habits and puts us at ease when we are disappointed
and many other things.

d. Movement

Physical activity is important for our well-being because it keeps our bodies
fit and healthy. Physical activities can benefit health if they are balanced
with the right amount of physical activity that is not too much or too little,
like running a marathon or roller skating on rollerblades without enough
physical exercise. Exercise increases endorphins, our natural painkillers.
Engaging in physical activities can also help to reduce stress and make you
feel calmer.

e. Mindfulness meditation

Mindful meditation is a practice that helps us to pay attention to the present

moment without being distracted by our thoughts or feelings, and it teaches
us to observe our thoughts as they come and go in an accepting manner
rather than trying to control them through thoughtless criticism or self-
criticism. Mindfulness helps us observe how we feel, our body sensations,
and what is happening around us in a non-judgmental way. It helps us to be
aware of our thoughts and feelings without judging them. It allows us to let
go of useless thoughts, emotions, fears, and worries. It brings acceptance
and freedom.

f. Gratitude practice

Reminding yourself of all the things you are thankful for and making lists of
them is a great way to increase your well-being and happiness. The benefits
of gratitude can be: We can appreciate the simple things, it gives us energy,
it helps us to be more present in the moment, and many other things.

g. Meditation on self-compassion

Meditation on self-compassion is a healing tool because it helps us accept,

forgive and love ourselves. It also allows us to accept who we are, with all
our flaws and differences, and be comfortable with ourselves.

h. Meditation on gratitude

Mindfulness meditation is a practice that helps us to pay attention to the

present moment without being distracted by our thoughts or feelings, it
teaches us to observe our thoughts as they come and go in an accepting
manner, rather than trying to control them through thoughtless criticism or
self-criticism. Mindfulness helps us observe how we feel, our body
sensations, and what is happening around us in a non-judgmental way. It
helps us to be aware of our thoughts and feelings without judging them. It
allows us to let go of useless thoughts, emotions, fears, and worries. It
brings acceptance and freedom. This mindfulness meditation also helps in
stress reduction, a meditation on gratitude can help you to feel grateful for
all the things you have; that is the beauty of life we all deserve.

i. Mindfulness at the workplace

Mindfulness is a practice that helps us to pay attention to the present

moment without being distracted by our thoughts or feelings, it teaches us
to observe our thoughts as they come and go in an accepting manner,
rather than trying to control them through thoughtless criticism or self-
criticism. Mindfulness helps us observe how we feel, our body sensations,
and what is happening around us in a non-judgmental way. It helps us to be
aware of our thoughts and feelings without judging them.

Stimulation of the vagal nerve-placebo as an alternative cure to

depression.
Stimulation of the vagal nerve-placebo is an alternative cure for depression.
It has been known to be an effective treatment and is less expensive than
common psychiatric drugs. Moreover, many side effects associated with
common psychiatric drugs, such as antidepressants, are absent when using
vagus nerve stimulation, while the symptoms of depression are treated
more effectively.

Surgical implantation is a non-invasive procedure that requires only a local

anesthetic. In this way, the body does not recognize it as a foreign object
and rejects it. Vagus nerve stimulation could be an option for those who do
not respond to traditional treatment methods, such as anti-depressants and
cognitive behavioral therapy.

There are also serious dangers associated with this method of treating
depression, some of which were discussed in Sarajevo as a treatable illness.
According to the book, people have had a seizure and heart attacks.
Although no deaths have been reported, this form of treatment is still new
and needs to be studied further.

Since mainstream medicine has yet to acknowledge the positive effects and
costs associated with vagus nerve stimulation, many choose to use
alternative methods for relieving their depression. The use of vagal nerve
stimulation is one alternative method that has proven beneficial for many
who suffer from depression.

In many instances, the patient's depression has not only been alleviated but
also eliminated with the use of this alternative cure. The cost of this
treatment has also proven to be significantly lower than that of traditional
psychiatric treatment methods such as drugs and psychotherapy. One issue
with vagus nerve stimulation is the fact that an implant is needed, which
requires a general anesthetic.

This fact may deter some from trying this alternative treatment method.
However, it should be noted that the implant is removable and small (1x1x1
cm). Thus, it would be easy to remove in case of complications or a desire to
discontinue the implant.

Vagus nerve stimulation is a non-invasive alternative treatment for

depression and has shown to be less expensive as compared to psychiatric
drugs. Furthermore, the patients have reported being free of side effects
from common psychiatric drugs such as antidepressants. This alternative
treatment method has also been more effective in treating depression than
standard drug therapy.

Specific nerve blocks may stimulate the vagus nerve by applying electrical
current at relatively high frequencies and low voltages to stimulate the
brain's hypothalamus or other parts of the central nervous system.

The vagal nerve is a branch of the autonomic nervous system that supplies
the viscera (heart, stomach, intestines) and part of the brainstem with
parasympathetic regulation, one component of which affects depression or
sadness. It also sends branches to many other organs in the body, including
two cranial nerves-X, VII-that regulate salivation and swallowing,
respectively. Therefore stimulation of the vagal nerve can affect mood
states in several ways.

Based on these concepts, vagal nerve stimulation has been investigated as a

treatment for depression. Interest in vagus nerve stimulation arose when it
was discovered that people with epilepsy, who have epilepsy-related brain
damage, were more likely to suffer from depression than otherwise healthy
people. This led to the hypothesis that overactivity of the brain area in
which this type of seizure started (the mesial temporal lobe) might be
responsible for depression and that stimulating the vagus nerve might stop
this area from firing so much by sending it inhibitory signals from the
parasympathetic nervous system. There is some evidence to support these
theories.
Vagus nerve stimulation is a day surgery procedure in a hospital or
outpatient clinic. The surgical implantation of the device does not require
general anesthetic but only local anesthesia. The last two decades have
shown that VNS therapy is feasible and safe in treating depression that has
not responded to conventional antidepressant therapies. This non-invasive
method has been used in randomized controlled trials and presented at the
Neuropsychopharmacology Conference in 2001. Depressed patients who
could benefit from vagus nerve stimulation are those with high levels of
anxiety, male patients, and patients with more than two failed
antidepressant treatments and electroconvulsive therapy (ECT).

Currently, there are two types of vagus nerve stimulation systems: a high-
frequency generator with a low-voltage device, and a low-frequency
generator with a high-voltage device. These devices must be surgically
implanted under general anesthesia with insertion into the vagus nerve
approximately 4 cm in length. An electrode that connects to the device is
successfully placed at the base of the skull, similar to ECT.

After surgery, patients may experience some dizziness and balance

problems. Patients using this form of treatment have reported improvement
in depression while on it; levels of depression appear to improve more over
time rather than suddenly after treatment has begun. This improvement is
also associated with a decrease in anxiety and an increase in mood
stabilizers such as lithium.

The actual cause of depression is unknown. Theories include imbalances

between the brain chemicals serotonin and dopamine levels, the
hypothalamus, and other parts of the central nervous system that transmit
motor signals to muscles, organs, or glands. Vagus nerve stimulation has
been used as a treatment for depression in patients who have epilepsy
found to have or be susceptible to epilepsy-related brain damage, who
suffer from depression. Neuroplasticity (which means that neurons can
reorganize) may also play a role in mood disorders; areas of the brain
responsible for learning and memory may be associated with mood
disorders.

Less commonly, the vagus nerve is stimulated by injecting cannulae at the

base of the skull and attaching them to the vagus nerve. This involves
applying electric impulses at a low frequency with a high voltage for two
minutes through a reusable electrode inserted in contact with the vagus
nerve stumps. It stimulates the brain’s hypothalamus and leads to a
reduction of anxiety and improvement in mood if it is effective.

Unfortunately, this technique is invasive and requires general anesthesia,

which may not be effective as an alternative therapy to VNS. The technique
is also associated with serious risks, including severe headache, discomfort,
numbness, or stroke of neck muscles. Another drawback is that the
procedure needs to be repeated every year, which decreases its usefulness
and convenience.

Therefore, only a few studies have been conducted to assess the effect and
safety of this technique on depression. Despite the benefits, this method is
considered a potent and alternative therapy but not as good as VNS.

Vagus nerve stimulation has been proposed as a treatment for anxiety

disorders. In one study with ten chronically anxious patients, six depressed
and four had a generalized anxiety disorder (GAD), vagus nerve stimulation
was an effective treatment for improving depression and reducing anxiety
levels significantly in individuals with comorbid GAD. However, the effect of
vagus nerve stimulation on reducing generalized anxiety disorder in
patients with comorbid GAD is unknown. Therefore, currently, there is no
evidence supporting the use of VNS for generalized anxiety disorder.

Although this method shows promise as an alternative therapy for

depression, the procedure has some limitations. The procedure’s
effectiveness has not been proven as first-line therapy for major depression.
Since the surgery is invasive and has some risks attached to it, to make sure
that this is an effective treatment, further studies need to be conducted
using randomized controlled trials with a large number of patients who
have major depression and comorbid generalized anxiety disorder (GAD). To
finalize its effectiveness in the treatment of comorbid GAD and major
depression, further studies should be conducted in the future.

Benefits of diaphragmatic breathing.

At the base of the lungs, a thin sheet of muscles called the diaphragm is
responsible for breathing. When you inhale, this muscle contracts and
moves downward, which allows your lungs to expand. When you exhale, this
muscle relaxes and returns to its original position. Diaphragmatic breathing
can make it easier for these contractions to occur with every breath.

When doctors first started learning about diaphragmatic breathing in

medical school, many experienced immediate reliefs from their asthma
symptoms and allergies when they practiced it regularly at home as
prescribed by their instructors. Following this procedure quickly improved
the quality of a patient's life and increased the effectiveness of their medical
care.

The beneficial effects of diaphragmatic breathing extend beyond the

respiratory system. It's been shown to improve the health and wellness of
people who suffer from allergies, physical disorders that cause pain, various
digestive problems, and other conditions.

The function and purpose of the diaphragm have been known for thousands
of years. Even though it was called the "windpipe," it didn't work like a
windpipe. Even though you can see the diaphragm at rest, there is no way
to tell from looking at it that it's in use. Only when you press on its surface
and feel it contract is this layer of muscle able to do something.

Diaphragmatic breathing may seem easy enough as there are only two steps
involved:

1) Before starting any exercise program, learn to breathe without tensing

your abdominal muscles or tightening your throat or jaw.

2) After you learn to breathe naturally, learn to breathe from your

diaphragm.

Once a person becomes familiar with their diaphragm, they often find that it
helps them in daily life and exercise.

Diaphragmatic breathing is:

• More efficient than other methods of breathing

• Easier and more comfortable than breathing through the mouth or nose
(directly into your lungs)

• Can be practiced anywhere and anytime

• Can be practiced by anyone, regardless of age or health condition

• Helps people with stress and asthma conditions

Diaphragmatic breathing is one of the easiest breathing methods to learn.

There are no special exercises or equipment required.

Here are some tips for learning how to breathe from the diaphragm:

1) Keep your stomach tight so the diaphragm feels safe, like a pillow.

2) Exhale through your lips by pursing them slightly, keeping them pressed
lightly around your lower teeth (like you might do when saying "ooh!").

3) Inhale through the nose (keeping it relaxed, like inhaling into your
mouth). Try not to cough during this step.

4) Raise your shoulders and gently pull them down toward your ears.

5) Continue breathing into your lungs for the rest of the exercise.

6) The more you practice, the easier it becomes to feel the muscles in your
chest working together with the diaphragm. Try to find a comfortable
breathing rhythm that feels relaxed, peaceful, and empowering.

A person who suffers from allergies or other conditions that cause pain are
often told by their doctors or physio-therapists to do deep breathing
exercises through their mouth as they lie in bed or on a treatment table,
which doesn't work very well as most people can't take much pressure on
their necks and heads with their arms bent at the elbows.

Diaphragmatic breathing is much easier for these men and women to

manage, as they can relax the muscles in their necks and heads during the
exercise. This type of breathing also encourages people to breathe better
overall.

The diaphragm has been known for thousands of years as the "windpipe" or
the "heart-lung" because it is responsible for breathing. It is located in the
lower abdomen, just above the stomach. The diaphragm is a thin, yellow-
white muscle about 8 inches in diameter that separates the chest from the
abdomen. The diaphragm contracts and relaxes with every breath, moving
down with inhalation and up with exhalation. Though you can't see your
diaphragm at rest because it's inside your body, you can feel its motions by
placing your fingers on top of your belly (in line with your navel). The
stomach muscles stay relatively still during breathing; they move only
enough to allow the diaphragm to contract and relax.

When you breathe, first inhale through your nose, then fill your stomach
with air and hold it there. Next, gently exhale through pursed lips by
pressing gently on your abdomen (lower belly) to feel the diaphragm move
downward and relax. Hold this position for a few moments, then inhale
again through your nose. Release the air from your belly in tiny puffs as you
allow the diaphragm to rise into its original position.

Start by practicing anytime, anywhere, for about 5-10 minutes. Try to focus
on gentle inhalation and exhalation of breath. If you focus on counting the
breaths, this is normal; try to let go of the numbers and return your
attention to the diaphragm and its movement. As your breathing becomes
more balanced, you may count your breaths again or not at all.

The body's nervous system is designed to send messages from one part of
your body (or even in mind) to another part of your body so that both parts
respond at once. This is called reflex action or a reflexive response. When a
signal reaches the brain or nervous system, its response is automatic,
without requiring conscious thought.

When you detect any warning signs of breathing problems (such as

unexplained chest pain), do not wait for the chest pain to occur before
beginning diaphragmatic breathing.

Diaphragmatic breathing can be used alone to reduce or eliminate the

symptoms of several respiratory ailments, including asthma, emphysema,
and chronic bronchitis. As with asthma, this technique has been shown to
reduce or eliminate the frequency and severity of attacks in people suffering
from emphysema. Diaphragmatic breathing is also a very effective tool for
relieving symptoms of chronic bronchitis.

Diaphragmatic breathing exercises can treat reflux, GERD

(gastroesophageal reflux disease), and many other gastrointestinal
problems.
One researcher said that diaphragmatic breathing is "the most powerful and
simple technique for treating many common illnesses." He concluded, "It is
a wonderful, simple technique that can help people who suffer from not just
one but many disorders. Once you learn how to breathe with the diaphragm
and practice it, you can breathe better most of the time and even enjoy new
health benefits."

Diaphragmatic breathing is especially helpful for reducing stress,

alleviating pain, strengthening your lungs and muscles, and improving
sleep. There are a variety of diaphragmatic breathing exercises you can
practice.

Diaphragmatic breathing is one of the easiest, most natural breathing

techniques to learn and practice. It is also a very inexpensive, simple, and
practical method of health care that is easy to learn and understand.

Therefore, it's worth a try if you or anyone you know suffers from asthma,
tension headaches, allergies, asthma, and many other problems.

- Diaphragmatic breathing reduces stress, improves your ability to deal with

pain, and lowers blood pressure. It also strengthens your diaphragm.

- People with asthma who practice deep breathing frequently find that their
symptoms disappear or become less severe.

- Some patients who suffer from chronic bronchitis report easing symptoms
just two weeks after they begin practicing deep breathing exercises.

- The deep abdominal breaths that help relieve stress create a "reset"
button in your brain that helps you return to normal after reacting to
stressful situations.

- People who suffer from reflux and gastroesophageal reflux disease (GERD)
usually have the most success with breathing exercises.

- Many people who practice deep breathing regularly can reduce or

eliminate their dependence on drugs for treating allergies.

If you frequently suffer from stress, anxiety attacks, or symptoms of chronic

bronchitis, it's worth a try. Do your research, find a place and time when
you will be free from distractions and interruptions for about ten minutes
each day for your practice sessions, and learn the art of deep abdominal
breathing.

The next chapter will discuss exercises. Exercising is important since

exercise strengthens the body and gives it a feeling of wellness. Exercise is
one thing that can help to improve your body. What you do for yourself
counts because, with exercise, you can strengthen your body and have
better health.

There are many things that you can do that will benefit your body. Having a
formal workout routine provides the greatest benefits for your physical well-
being, but it's important to remember that exercise isn't only about physical
fitness; it's also about emotional fitness. Exercise helps boost self-esteem
and feelings of self-worth, which are crucial components of emotional
health. The more energy you have, the better you feel about yourself,
improving your confidence level. Exercise can give you a new lease on life.
Start by finding an exercise program you enjoy and will stick to, then set
realistic goals. Observe your progress by measuring and weighing yourself
regularly.
Chapter 6. EXERCISES
 Exercise on restoring mutual commitment.
Mutual commitment is not given or taken but is mutually created by both
parties.

To restore mutual commitment, you should look for opportunities to do

things together in which you can experience a sense of satisfaction and
accomplishment.

As with anything valuable, it takes some work and effort to maintain the
beauty and quality of this "mutual commitment." It might take a little more
time, but the rewards are well worth the effort. You may have to sacrifice
your pursuits for a while, but soon enough, the road ahead will be clear and
open with no surprises waiting around the corners.

You deserve an energetic partner who feels fortunate to walk down it with
you. Therefore, exercising mutual commitment is a great way to find that
partner. Moreover, restoring mutual commitment will keep your
relationship healthy and vital in the years to come.

Exercising mutual commitment is something that you and your partner can
do together. This is a step toward gaining more appreciation and meaning
in the marriage. However, it is not so much of a commitment where you will
be required to give up all your other interests or activities. It requires a
little work to keep a warm, happy relationship with each other over the
years.

There are several exercises that you can use to restore mutual commitment
between each other. The most effective exercise for bringing about this end
will be for every partner to make time for at least one hour each day to be
alone on purpose. Extend the time with each other to an hour or two if you
can. This alone should begin a mutual process of commitment for each
other.

Therefore, exercises that can restore mutual commitment are:

a. Exercising together - you can take up a sport such as joining a gym or

going for walks together, taking a dance class, or hiking. Just find
something that interests both of you and do it.
b. Talking about the future - discussing the children, your dreams and goals
for the future, and your financial plans for saving money and buying a home
will also strengthen the commitment to each other.

c. Having friends over for dinner - having friends over for dinner on
occasion will let your partner know that his/her company is valuable to you
and worth investing in by making time for him/her.

d. Making Life Choices Together - making decisions, such as what to eat,

what clothes to wear, and where to go will help you feel more connected
and responsible for each other. This is especially challenging when choosing
what to wear.

e. Using your talents together - using talents such as music, art, sports, and
dance together in a manner that enforces cooperation and unity will also
build you up emotionally and strengthen mutual commitment.

f. Making time - making time for each other can be very frustrating. It is not
as simple as it sounds. This exercise requires you and your partner to
overcome the difficulty of setting aside personal agendas, schedules, and
individual interests to focus on each other for a few hours each day. By
making time for each other in this exercise, you will develop a bond of
appreciation for your partner's value in your life.

g. Celebrating the good times - a great way to strengthen mutual

commitment is to celebrate the good things that have happened during the
day or at the end of each week. This can be as simple as sharing a meal or
going out for ice cream.

h. Having shared interests - finding common interests with your partner will
make it easier to create a sense of mutual commitment. Whether it be
cooking, collecting artwork, or gardening, these shared interests will help
you appreciate each other's values and what is important to one another in
life.

i. Visiting with friends - this is not always possible, but going out in public
together will help you feel more connected and help build commitment
between you over time.
j. Showing appreciation is a great way to strengthen your commitment to
one another. It does not take much time or effort, but it could make all the
difference in the long run.

k. Reading to your partner - reading books will help you gain insight into
others' experiences, which helps you appreciate life in general and each
other as individuals and as a couple.

l. Building a family history together - working together as a family to write

down your family history, stories of how you came together, and how your
children were born will help strengthen commitment between generations
and generations of parents and children.

The neurofascial release technique.

This therapy improves one's quality of life through self-manipulation and
exercises.

The neurofascial release technique is the therapeutic use of manual

therapies and techniques that release restrictions in body tissues, reduce
pain, create motion, and increase function.

Therapies such as massage can re-establish fluidity in muscles that may

have become "knots." Once muscles are more relaxed and distended, they
are better able to expand and contract as needed. Massage techniques often
include kneading the muscle with the thumb or fingers or using a stationary
pressure point such as a particular tender spot on the back.

Physical exercise is also used for treating and managing musculoskeletal

pain and may include stretching, isometric exercises, resistance training,
cardiovascular exercise, and aerobic exercise. However, ensuring that an
individual has warmed up first is important, as this reduces the risk of
injury. Special types of exercises are designed to be gentle on the body but
still provide a good workout, such as Pilates.

Aerobic exercise has been found to decrease muscle tension in women with
fibromyalgia (FM).

Massage therapy is a profession that has been around for many years. Its
use has spread from medical specialists to the general public. The
popularity of massage has increased tremendously in recent years due to
the rising number of massage therapists and schools which offer training.

For therapy to be effective, certain variables need to be in play; these

variables include the therapist having proper qualifications and experience,
a client having an understanding of what he wants from therapy, having an
open mind and being relaxed, as well as therapist's willingness to work with
client's individual needs.

The number of people with musculoskeletal pain and discomfort increases

yearly due to increased working hours, stress, poor diet, and sedentary
lifestyles. This has led to a demand for a massage therapy as an effective
treatment alternative.

A therapist can improve a client's quality of life by teaching him how to self-
manipulate certain structures in his body and then using techniques that
release tension, reduce pain and create motion.

With the increasing use of massage therapy, it has also become a popular
field of study. It is now possible to find schools that offer certification and
continuing education units for practicing therapists.

Massage therapy is very effective because it allows one to focus on

particular areas causing discomfort and then provides relief through
manipulation of the soft tissue.

Scapula and Upper Back: By massaging the upper trapezius, upper

trapezius, rhomboid, and levator scapulae, the practitioner can enhance the
range of motion in the scapula and improve the function of the deltoid
muscles.

Shoulder: The cross-side stretch is excellent for a client who experiences

pain when they are asked to do overhead work. Also, this movement will
stretch out the scapulothoracic fascia and loosens tight muscles in the
anterior shoulder.

Forearm: Hand massage will reduce muscle spasms and increase circulation
at a point very close to nerve fibers. Also, this is a great move if you have
been hurting with strained hand muscles.

When to use neurofascial release technique:

• Enhance quality of life through self-manipulation and exercises.

• Treat pain and discomfort.

• Open up restricted tissues in the body.

• Treat frozen shoulder.

• Reduce pain during recovery from surgery.

• Reduce fibromyalgia symptoms and improve sleep quality.

• Rehabilitation of injuries.

• Reduce tension and increase flexibility in the body.

• Restore range of motion at joints.

• Increase blood circulation to the musculature.

• Improve function and reduce symptoms associated with RSI (repetitive

strain injury).

The neurofascial release technique can be used on itself, but it can also be
used in conjunction with other techniques, such as manipulation, massage,
or exercise. The objective is always to improve quality of life through self-
manipulation and exercises.

How to use neurofascial release technique for social engagement:

• To be successful with this technique, you need to have a positive and open
mind.

• To get the best results, you must desire to change.

• During this process, you must always be committed and ready to learn
new techniques and exercises.

• Neurofascial Release Technique can be introduced to complement other

techniques that may help shyness or social discomfort, such as cognitive
behavioral therapy.

The neurofascial release technique helps clients manage anxiety, social

anxiety, or shyness by promoting normalization behavior that is acceptable
in different situations.
 The salamander exercises.
Salamander exercises are essential since they strengthen the muscles of the
heart and lungs, which can protect against heart disease and lung diseases.
Generally, they are performed by exhaling while sitting up straight.

They can be done at home, but it is preferable to do them in a special room.

Though these exercises are beneficial, it is a good idea to ask your doctor or
another health professional beforehand if you are depressed or have any
other preexisting medical conditions. Moreover, ask if the exercises are
right for you or if there is a better alternative.

The following steps guide you through the regimen of salamander exercises:

(1) Grip bar. Stand up straight, with your eyes closed. Place your hands
onto a bar held tightly at shoulder height, with your arms extended out from
your body; palms down. Then lean back until you feel like you are about to
fall backward. When this happens, let go of the bar and gently sit down on
the floor, landing on your feet with legs and knees slightly bent.

(2) Lay-back on inclined board. Lie down on an inclined board; your head
should be folded over your hands, with your elbows tucked into your side.
Tip: Your head should be positioned so that the curve of the board forms a
gentle S-shape when you're lying on it.

(3) Hanging with elbows and hands. Enter a hanging position with your
arms extended out from the sides of your body, elbows down, and fingers
touching next to the head. Tuck in the toes and rotate one arm downward at
a time; then rotate them both inward again until you reach a vertical
position, elbow tips touching the sides of your waist.

(4) Lay back up against a wall. Lie down on your back, with your arms
stretched over your head and your hands clasped. Then slowly lift your head
off the floor until it's perpendicular to the floor. Keep your elbows bent and
slightly tucked in at your waist's sides while doing this.

(5) Lay back on an inclined board so that neck is straight up and down. Lie
on an inclined board with a slight curve at the neck, facing away from the
wall. Keep both arms extended out from the sides of your body, elbows
down, and fingers touching next to the head; then rotate one arm downward
at a time; then rotate them both inward again until you reach a vertical
position, elbow tips touching next to the side of your waist.

Your joints, muscles, and ligaments are your body’s natural shock
absorbers. They can be a major factor in how you feel throughout the day.
Joints and ligaments provide stability for the bones that make up our frames
so that we can move about without being in pain or suffering injury.
Muscles are what allow us to move around, from running down the street to
writing our thoughts on paper.

There are two types of salamander exercises:

• Half salamander

This is when you raise your head and shoulders off the surface of the
ground but continue to push your lower body away from the ground. In
addition, tip: keep the head and shoulder raised, so the back of your head
doesn’t touch anything other than the ground.

This exercise helps strengthen the neck and abdominal muscles, so they
don’t become weak and lifeless.

• Full salamander

This involves raising your entire body off the floor, with your hips, knee, and
toes still on the ground. In addition, tip: keep your head, shoulders, and hips
raised off of the floor to maintain a balanced position.

This exercise helps strengthen the back muscles and improves spinal
flexibility; it also strengthens the chest and abdominal muscles for optimal
breathing capacity.

Here is an example of a full salamander exercise: Place hands on a bar

behind you with your arms extended out from your body; palms down. Then
lean back until you feel like you are about to fall backward. When this
happens, let go of the bar and gently sit down on the floor, landing on your
feet with legs and knees slightly bent.
There are no contraindications for salamander exercises; however, if you
feel light-headed or nauseous while doing them, tip: put your hands on a
sturdy surface by your side until you feel better.

Salamander exercises are not very expensive, as most of the equipment can
be found at home or bought for a low cost. Moreover, there is no need for
specialist physicians or therapists to perform them. Therefore, they are
widely used and practiced in countries where health insurance is not widely
available.

Massage for neck tension release.

Neck tension can lead to neck and shoulder pain, headaches, and even
injury. This exercise can help release tension in the neck and relieve
fatigue.

The goal is to release pressure in the muscles of the neck. The best way to
do this is by massaging with your fingers (or a tennis ball).

1. Sit in a chair and put a tennis ball under your neck, wedging it between
the floor and the top of your back.

2. Slowly roll from side to side, letting gravity work—this will take some
time as you are not moving much just yet.

3. Once you feel you have released the muscle enough, move your neck in a
circular motion to stretch and twist the muscles.

4. Move your neck in a back-and-forth motion to loosen up the neck muscles

even more. You might feel like you are dizzy, but that is normal! This means
that you are releasing tension in the muscles of your neck.

5. Roll around on the floor some more, as this will help eliminate any aches
and pains. After a while, you may feel more relaxed and refreshed.

This exercise is essential since neck tension can cause neck and shoulder
pain, headaches, and even neck injury.

Lie down on the floor with your back on the ground and your head resting at
a 45-degree angle. Place a small towel under your forehead to prevent it
from getting dirty. Grasp the area close to your neck and pull gently
towards you in an upside-down U shape. Do this 10 times and switch to the
other side of your neck for 20 reps for optimal results.

Exercise: Neck Tension Release

Do this massage 10 times, alternating between the sides of the neck. This
will help relieve tension from around the level of the thyroid cartilage,
giving you relief from pain or pressure caused by muscular tension around
it (elevated hairline).

Neck tension release can enable people to:

a. Reduce pain and pressure around the level of the thyroid cartilage, which
is frequently caused by muscular tension.

b. Relieve head and muscle tension (reduces pain and tightness).

c. Relax your shoulders, making it feel easier to turn your head.

d. Feel more relaxed; feel your body’s natural healing process kick in faster
to heal tension/pain/discomfort related to neck or thyroid cartilage level.

Repeat 10 times on each side.

If you are prone to headaches, make sure you do this exercise daily because
it will help to release the body’s natural healing process and help prevent
headaches in the first place.

Step 1: Sit up straight with your feet flat on the ground just above your
knees, feet relaxed and shoulder-width apart.

Step 2: Cross your arms at chest level in front of you. Fingers should be
together, palms facing down. Keep elbows tucked close to body as shown in
the photo.

Step 3: Lift your arms overhead to make a right angle between your torso
and arms (as if you were hugging a tree). Lower your arms back down to
the starting position. Repeat 10-20 times.

Repeat 3-5 times daily until tension is relieved. If you experience pain,
continue doing the exercise until you feel relief from the pain.
(Remember this exercise if you want relief from tension when driving &
difficulty turning your head)

This exercise helps to relax and stretch the tight neck, shoulders, and upper
back muscles caused by muscle tension or stress in other body parts. For
example, tightness in the lower abdomen can affect tension around the neck
or thyroid cartilage level. Also, tightness in the back can affect tension
around the neck or thyroid cartilage level.

It also helps stretch and loosen muscles around the neck and thyroid
cartilage level, allowing it to turn more freely, alleviating tension in this
area. Suppose you don’t regularly do this exercise and are experiencing
tension in your neck, shoulders, or upper back. In that case, it is a good idea
to start doing this exercise daily to loosen up stiff muscles around your neck
and thyroid cartilage level. This exercise is also great if you have frequent
upper back or neck headaches. It will help to release tension in these areas,
helping to prevent headaches.

SCM sore neck exercise.

The winter months often bring a decrease in the amount of physical activity.
This can lead to muscle stiffness and soreness. The neck is one area that
can be affected by prolonged periods of bad posture from hunched
shoulders, tense muscles, and poor sleep habits. It can cause pain at the
base of the skull, migraines, difficulty swallowing or speaking, headaches,
sinus pressure, congestion, and other symptoms. The intense pain often
leads to stiff necks, chronic headaches, and sleep disturbances that can
impair our daily activities. It is recommended that anyone experiencing
neck pain should seek professional medical advice to prevent any serious
complications. This can sometimes be done at home by performing the
following exercise.

Sitting in a reclined upright position, place the palm of one hand on your
head, and squeeze your neck muscles in a circular motion with your other
hand. To make sure you are using as much of your neck muscles as possible,
contract them slightly upwards. It is advisable to stretch these muscles
after you have finished this exercise.
To help prevent a stiff neck from occurring again, it is recommended that
the following tips be applied:

a. Maintain good posture, especially when sitting and standing.

b. Avoid slouching, which can lead to muscle stiffness.

c. Stretch the neck muscles before bedtime to maintain the range of motion
in your neck and avoid stiffness while sleeping.

d. Get a good night's sleep regularly, as having poor quality sleep can lead
to pain and other problems associated with the neck area.

e. Pay attention to your posture when using electronic equipment such as

phones or computers so that you do not become slouched over them.

The SCM muscle consists of a long band of skeletal muscle extending from
the neck's front and side to the upper back. It is located in front of the
scalene muscles and on the sides of the trapezius. This muscle plays an
important role in turning our head, moving it sideways, and tilting it
downwards towards our shoulders, such as when we look at something
below us, such as when getting out of bed. The main role of this muscle is to
keep our heads steady to help prevent dizziness and weakness, which can
occur after prolonged periods of poor posture or due to other factors such
as stress or fatigue.

Avoid any posture causing the problem (e.g., sitting or driving while sitting),
and don't rest against a car seat when driving. Do not turn your head too far
sideways, leading to pain and muscle stiffness.

Always look straight ahead and keep your eyes level with the horizon. Make
sure the top of your head is not tilted downwards, which can cause
dizziness or neck pain if you lean forward too far.

A good way to test the strength of your muscle is to hold a pencil between
the fingers of one hand and observe how much pressure it takes to hold it
steady in front of your face. Try holding this pencil level with a fingertip tip
against the middle finger (not touching it), then try holding it firmly against
your forehead so that both fingertips are touching. This should be hard
enough to maintain it in position without dropping it but not too strong as to
hurt afterward.
SCM sore neck exercise: Stand with your head backward and shoulders
back while keeping your eye focused on a point between the floor and
ceiling. Let your arms hang at your sides and bend your torso forward,
keeping your chin down and looking straight ahead (a). Slowly contract your
sternocleidomastoid muscle until you feel the tension in the neck region.
Maintain this contraction as long as you can. Avoid bouncing up and down,
as this will increase potential strain on the SCM muscle. Repeat 10 times
with a 2-minute rest after each exercise.

This exercise, if regularly practiced, will help control headaches, migraines,

and muscle spasms. Also, it will strengthen the sternocleidomastoid muscle.
This exercise is essential since it strengthens the muscle and relieves pain.
Moreover, exercise can prevent chronic headaches and migraines.

Proper posture is important in maintaining health and reducing the

frequency of headaches. You can maintain proper posture and reduce lower
back pain by performing these exercises. The exercises can be done while
sitting in a chair or lying down.

Twist and turn exercise.

Twist and turn exercises are verticle exercises you can do at home. All you
need is space with enough floor space for jumping and a chair or bench.

It helps to have someone that can spot you while doing this exercise.

Start the jumping portion by standing on the floor before your jumpable
surface. Twist your body to the right so that your right arm is over your
head and your left leg is straight out behind you, making a 90-degree angle.
Jump as high as possible and afterward land on the straight leg without
letting either foot touch down first. Switch legs before twisting back to
jump, and keep alternating until time runs out. The more twisted you are,
the harder it will be, but the better your oblique muscles will get.

If you don't have a jumpable surface, use a chair or bench instead and start
standing on it.

This exercise can be performed with one or two legs. The two-leg version is
usually harder than the single-leg version because of the added weight on
one foot simultaneously when landing, so it's preferable to start with one
leg before trying to do both.

Start this exercise by standing with both feet on either side of a bench in
front of you. Put both hands on your hips, and bend forward at the waist, so
your torso is parallel with the floor. Simultaneously extend all four limbs
before you, ensuring your knees are bent, and your ankles keep their
pivoting points. If you notice one leg is going out of the "legs" line,
straighten it while remaining in a leaning position as if doing a two-legged
twist and turn. Land on the same foot if it's still out of place when
alternating legs next time.

Once you can do this exercise without any issues, start doing it without
touching any surface, just standing still on both feet. The only thing you'll
use is your balance.

This exercise mainly works on your abdomen, and starting with one leg is
easier before trying to do both.

Start this exercise by sitting on the floor with your legs straight out in front
of you. Have knees bent so they are at a 90-degree angle, and hands are
placed palms down on either side of your body. Keep back and spine
straight, not leaning forward or backward.

When lifting, try to rotate your torso as close to 90 degrees as possible

before moving it up further by extending at the knees. When lowering down,
also do this in a controlled manner where every part of the body moves at
once while keeping the back and neck straight.

Jumping jacks on the bench.

If you can't quite reach the floor with your feet during the twist and turn
exercises, you can also do this exercise seated. Just be careful not to jump
too carried away and miss the bench. All you need is a bench or chair and a
place to jump from.

Start by sitting on the edge of the bench with your feet facing forwards.
Start reverse jogging (backward) off of the bench. When one foot reaches
the floor start jumping jack style, stomping down hard on the floor for
maximum jumping height, then switch feet before landing on the bench
again.

Explosive jumping.

Some people find getting more power in their jump easier if they start with
a small leap, then launch themselves into the air as high as possible.

This exercise is also great for developing quick bursts of power. All you
need is a floor wide enough to give you a good running start and enough
room to jump around when you land. Start by gradually speeding up your
running speed until you have a good head of steam, then take off into the air
with both feet as high as possible, alternating legs on each jump without
touching down first. If you're jumping onto a hard floor you can add more
power by holding your hands above your head with the thumbs touching
each other.

Start standing on the floor in front of your jumpable surface. Jump up as

high as possible, land on that same leg, then switch legs before landing on
that same side; keep alternating until time runs out. If you're having
difficulty keeping up with this exercise, it can help to hold onto something
above you so that you can reach higher. 5-minute workout. Do 60 jumping
jacks, 30 twists and turns, and 15 explosive jumps.

12 vagus nerve stimulation techniques.

1. Set up your vagus nerve stimulator before going to sleep by keeping it
plugged in and turned on all night.

2. Set your timer to go off every hour throughout the day, and then turn it
off instantly when the alarm goes off without moving or making any noise at
all.

3. Spend an entire day without talking except when necessary (i.e., ordering
a menu item).

4. Wear a fake mustache or other false facial hair throughout the day and
avoid speaking with people as much as possible, so you don't have to
remove it if necessary

5. Don't speak at all during a movie or TV program

6. At the end of a movie or TV program, turn down your hearing aid or
cochlear implant to the lowest volume setting and keep it turned that way
for an hour.

7. Sit in front of the TV and don't turn it on. If you get bored, go occupy
yourself with another activity before turning it on again after one full hour.

8. Whenever you go anywhere, take a walk before you get there instead of
driving, and then determine whether your destination is more than 10
minutes away from where you are standing (or walking).

9. Lie down on your back in bed and then stand up again using only your
willpower.

10. Whenever you are tempted to speak, count silently in your head for 15
seconds instead.

11. If you start to feel the urge to speak out of the blue, walk away from any
people around you and make sure your hands are occupied with something
(e.g., fidget toys).

12. Instead of saying anything whenever someone asks you a question, just
shrug both shoulders instead (i.e., make a non-word sound with both
shoulders).

Vagus nerve stimulation techniques are essential since people who use
them can maintain a higher level of control over their tinnitus and other
misophonia symptoms than those who do not. However, they must be used
carefully since over-exercising can cause more harm than good. Moreover,
there are several ways to increase the activity of the vagus nerve naturally,
so it's a good idea to explore them first.

This stimulation forces your body to be more active and thus more alive.
The most common vagus nerve stimulation exercises involve physical
activities such as walking, jogging, weight lifting, etc.

To get the most out of your vagus nerve stimulation exercises, you need to
keep them simple and repetitive so that you can stick with them long
enough for your body to get used to them. Repetition is important because
it helps your mind learn to accept certain tinnitus symptoms as "normal."
Walking is one of the best forms of vagus nerve stimulation exercises since
it involves physical and mental activity. It also doesn't involve talking, so
you won't have to worry about breaking your silence rules.

Another great thing about walking is that it can be done anywhere, at any
time. All you need to do is lace up your shoes and step out the door.

If you want to walk in your home, go ahead and do that; however, if you
want to take a walk outside, then make sure you're near some other people.
This helps make sure that your tinnitus symptoms don't get worse. Some
people also find it helpful to listen to white noise or similar sounds by
walking near a running car or along a busy street.

One important vagus nerve stimulation exercise I often do is called the

"shoulder shrug." The premise is that you're trying to shake off all your
tinnitus symptoms. In this case, the shoulder shrug is a visual trick that
forces you to shrug your shoulders.

First, imagine a weight hanging from each shoulder, and then try to raise
them in one fluid motion before you shrug your shoulders. This exercise
should be done first and then gradually speed up until it becomes difficult
for you to keep it going for any length because of how easy it becomes.

Another incredibly useful form of vagus nerve stimulation exercise involves

prayer. Prayer is simply speaking out loud and wishing for your tinnitus,
hyperacusis, and misophonia symptoms to disappear. You can do this
exercise daily or whenever you feel the urge.

The idea behind prayer is that if you keep it up long enough, your mind will
eventually start accepting that your tinnitus, hyperacusis, and misophonia
symptoms aren't going away by themselves. One of the best vagus nerve
stimulation exercises involves music. Music has a very strong effect on our
emotions and thus has a powerful impact on our moods.

The next chapter will discuss useful tools that can assist in putting the
therapies into practice. These tools include tinnitus maskers, sound
generators, and hearing aids. Therefore, knowing what these tools are and
how to incorporate them into your tinnitus management strategy is
essential.
The chapter, will discuss the most common tools used to manage tinnitus.
You will learn all the basics and how to incorporate them into your
treatment program. For example, Tinnitus management is not easy and
requires a lot of work, but at least now you can have some help with the
basics of tinnitus therapy.

These tools make it possible to reduce stress and control the severity of
symptoms. In addition, hearing aids can provide better outcomes for people
with hyperacusis by allowing them to hear better than they could without a
hearing aid.

Although acupuncture is not a method for treating tinnitus itself, it can help
you cope with your symptoms by reducing stress and helping you relax your
body to fall asleep at night. This can be very useful for people who have
problems getting rest at night because of their tinnitus symptoms.
Chapter 7. USEFUL TOOLS
 Tools that help put the therapies into practice;
These tools are very useful in managing both early-onset and late-onset
cases. Therefore, psychotherapists should use them in their practice.

These tools include:

a. Clinical interview schedule (CIS)

This tool is very useful tool in evaluating various kinds of OCD. It

determines the nature, content, obsessive and distressing thoughts. This
tool will help the psychotherapist understand the patient's symptoms better
and find out if there is any connection between them.

b. SET and IST

This tool can determine the severity of the patient's symptoms and whether
any psychological problem exists. This tool also helps to determine whether
the patient is impulsive, whether he has more obsessions or fewer
obsessions, etc.

c. Cognitive Behavioural Therapy (CBT)

This tool helps eliminate OCD from the patient's life by altering how he
thinks about himself and his fears. The psychotherapist will have to guide
the direction after evaluating information about a particular anxiety
problem. CBT commonly uses ideas such as "positive" thought, "self-
statements," and "self-control."

d. Exposure and Response Prevention (ERP)

Once the obsessions are identified, the psychotherapist will help the patient
to face his fears. This tool involves "exposing" the patient to the feared
situation, idea, or activity in a safe and controlled manner. The treatment
continues until the patient is able to face his fear for an extended period
without responding with compulsions (for example: wash, check, re-check,
avoid, etc.). This is called "exposure," and once these fears are no longer
causing distress or anxiety, they are referred to as "no-longer-feared."
Finally, once patients can abstain from performing compulsive behaviors,
they are referred to as being in "response prevention."
e. CBT-F

Cognitive Behavior Therapy-f is a manual of cognitive behavioral therapy

that effectively treats OCD in children and adolescents. This therapy helps
to build "self-efficacy," which is a person's belief that he/she can cope with
life's problems. The treatment comprises four stages:

1. Awareness (includes information about OCD)- developing an

understanding of what OCD is, who suffers from it, and how serious it can
be;

2. Education (this encourages children to talk about their fears);

3. Mental strategies (the necessary skills for managing their fears) and;

4. Cognitive restructuring (their belief about themselves).

f. Response prevention

Response prevention is an approach to preventing anxiety-provoking

behaviors by avoiding the situations that generate them. In OCD, this can
be as simple as telling a person to avoid doing an activity instead of
performing it compulsively. For example, a patient who is obsessed with
germs could be asked to wash their hands and not wash again, or they could
be asked not to wash and not touch anything. Or if they touch something,
they could be asked to touch a clean part of their body, such as their
tongue, without touching the rest.

g. Comprehensive assessment and referral tool (CART)

This tool is used to help identify the most appropriate treatment for a
particular patient. This helps in identifying the best treatment to be used
first and middle-wisely. The assessment also helps identify any comorbidity
with other disorders, like substance use, depression or anxiety disorders,
etc.

h. Measure of the severity of obsessions and compulsions (MOS-OC)

This tool helps in helping to assess the severity of OCD symptoms by

performing a checklist that measures the degree of obsessions, rituals, and
compulsions in a patient's life.
i. Yale-Brown Obsessive Compulsive Scale (Y-BOCS)

This tool helps assess the severity of OCD by observing the urge the patient
has to perform a certain task, the time it takes to complete it, how much
distress there is from doing them, and if he can control them.

j. Overt Response Counting (ORC)

This is an effective tool for identifying and tracking compulsions by counting

overt activities such as hand washing or hoarding. Obsessions are also
recorded on a 10-point scale, which helps determine whether there is an
obsession.

k. The Coping Strategies Questionnaire (CSQ)

This questionnaire can be used to document the coping strategies of a

patient, and it is a good screening tool. This tool helps identify the problem,
monitor changes, and give feedback. The patient and therapist can use it to
give feedback to each other.

l. Yale-Brown Obsessive Compulsive Scale for Children (Y-BOCS-C)

This tool helps assess the severity of OCD by observing the patient's urge to
perform a certain task, the time it takes to complete it, how much distress
there is from doing them, and if he can control them.

m. Perceived Competence Questionnaire (PCQ)

This tool obtains information about a patient's perception of competence.

The tool helps the psychotherapist to determine if the patient has a high or
low level of competence; it helps in understanding if they can cope with
life's problems.

n. Obsessive-Compulsive Inventory for Children and Adolescents (OCI-A)

This questionnaire is used for children between the age of 8 and 18. It helps
assess their symptoms in terms of time spent on their obsessions, number
and severity of rituals, amount of distress experienced from performing
compulsions, insight into OCD through rating scales, and quality of life.

Many pharmacological, psychological, and alternative methods are available

to treat OCD. Medication is usually the first line of treatment for patients
with OCD. The two most common medications used to treat OCD patients
include serotonin reuptake inhibitors (SRIs) and selective serotonin
receptor inhibitors (SSRIs). Some commonly prescribed medications are;
clomipramine, paroxetine, fluvoxamine, sertraline, citalopram, and
escitalopram.

Clomipramine is a tricyclic antidepressant that helps improve obsessive

thoughts and compulsions by increasing serotonin levels in patient's brains.
The medication at lower doses gives a modest response, while at higher
doses, it achieves a much better response. Common side effects include
drowsiness, constipation, dry mouth, and weight gain.

Paroxetine is the only antidepressant that inhibits both serotonin and

norepinephrine uptake. Paroxetine is effective in treating OCD in children.
The medication can lead to mild side effects, including insomnia and
anorexia nervosa.

SSRIs are derived from tricyclic antidepressants but are less risky for side
effects since they act primarily on serotonin receptors on nerve cells rather
than affecting neurotransmitters like norepinephrine. SSRIs are not
effective in treating childhood-onset OCD. Studies have shown that SSRIs
can help reduce the time of onset, frequency, and severity of OCD
symptoms if taken regularly. Some common side effects may include
nausea, sexual dysfunction, headaches, agitation, and insomnia.

Selective serotonin receptor inhibitors work by inhibiting the reuptake of

serotonin and other neurotransmitters from the synaptic cleft; these effects
manifest with a delay of up to one to three weeks after administration. They
are effective in treating adults with OCD but are less effective for children;
these medications also pose a higher risk for side effects which is why they
should be taken cautiously.

Alternative treatment options are also available to treat patients with OCD.
Cognitive behavioral therapy (CBT) is a common psychological intervention
method that helps patients with distorted thoughts and negative feelings
about their obsessions and compulsions. CBT helps the patient understand
their problems and find out reasons for behaving obsessively.
Another alternative to medication is deep-brain stimulation (DBS), which
can effectively reduce the severity of OCD symptoms by making the
treatment permanent.

In terms of prognosis, research shows that OCD has a higher relapse rate
after treatment than other psychiatric disorders; this may be caused by
continued exposure to compulsions and obsessions (not performing them
can lead to more anxiety).

The next chapter will discuss anxiety, fear, and rewinding the mind. These
three topics have been known to affect many people. Anxiety can be
physical or psychological. Anxiety can also be brought on by stressors or
situational factors, even in daily life. Examples include a bad day at work, a
traffic jam and long line of cars, a tornado warning, animal attacks, and
medical emergencies. Fear is often associated with anxiety; however, it has
nothing to do with anxiety. Fear is a form of protection that helps keep you
safe from danger and threats. Many things can cause one to be fearful such
as if they see other people being attacked by animals or if there is a tornado
rolling into their town. When one is fearful, one may be aware of the danger
but not know why. The body produces the fight or flight response, and then
the body goes into a state of fear. This can result in many physical
symptoms such as; sweating, trembling, raised heartbeat, excessive
salivation, and even vomiting. When it comes to rewinding the mind, it is
where someone tends to replay past events repeatedly. Some common
examples include when someone goes over things they said or did that they
later regret or can't undo or if they simply want to relive an event just
because it was a good time.
Chapter 8. BONUS
 How to prevent anxiety, fears, depression, and
anger from coming back.
When you learn how to treat your brain, it will be easier for you to handle
stresses in life and not give into the common traps that cause anxiety,
depression, and anger. It is depressingly easy for our brains to spiral
downward even when we have the slightest bit of trouble with our lives.

Treat these stressors quickly and effectively before they consume your
thoughts and make you feel out of control again. You can prevent these
feelings from returning by trying simple techniques that focus on the basics.

* Start with a warm and supportive environment.

If you feel sad, seek out someone with whom you can express your emotions
and be open about what's going on in your life. If you are feeling depressed,
love yourself and realize that it's okay not to be okay. Don't overthink what
has happened because it will just make everything harder to deal with.
Don't try to move on until you have dealt with the problem hasn't let go of.
This is the first thing to focus on when dealing with anxiety, depression, and
anger.

* Treat your sleep and diet.

When you struggle with anxiety, depression, and anger, it is common to

experience sleep disorders that keep you from getting a good night's rest.
Besides being fatigued because of this lack of sleep, you will also be more
anxious, depressed, and angry than normal. The same goes for not eating
right or consistently (this can cause many other issues as well). Not only is
it important to take care of these things for the sake of your mental health
but also your physical health.

Your body needs all the energy it can get to function properly. You will have
issues later in life if you don't exercise regularly and eat well. Your body is
your temple, and who will if you don't take care of it?

* Relax and meditate.

This is always a good thing to do. When you relax, your brain can then
better process everything around you. It will also help you focus on what's
happening in the present moment so that you won't be worrying about the
past or obsessing over the future. Many studies have proven that meditation
can help ease anxiety, depression, and anger, so why not try it out?

* Read or listen to something that makes you think.

This applies to any kind of reading, listening, or learning experience (even

watching a show. Just make sure it makes you think and doesn't make you
scared of the unknown). When we are worried, angry, or sad, our minds will
work overtime to figure everything out. This can lead to depression, anxiety,
and anger. It is your mind's way of trying to protect you from the bad things
that have happened in life. This causes us to react when we don't like what's
happening around us because it is all our brain's fault. You don't have to be
sad all the time just because your mind controls that way of thinking.

* Don't try to solve a problem quickly when it first shows up (or even later).

As I said before, our brains will work overtime when we are anxious,
depressed, or angry. They are trying to protect us from worrying, stress,
and scared. This means you are more likely to get upset than you normally
would have had you not reacted the first time.

* Find healthy hobbies and outlets.

To deal with anxiety, depression, and anger, we must do something to

reduce our stress levels. We must have healthy outlets for our feelings
because they will build up over time.

* Don't cast judgment on yourself.

When we judge ourselves, we place ourselves in a situation where we feel

bad about ourselves. It is amazing how the human mind works. All it takes
is one judgmental thought to completely ruin your mood. Don't tell yourself
that you are not good enough or capable of something just because you feel
like you can't do it. Telling ourselves that we can't do something right away
creates stress and anxiety because the brain thinks that if it did attempt to
do what was asked, life would be worse off in the end. You will have sooner
or later realized this is not true after dealing with anxiety, depression, and
anger for a time (I'm sure).

* Don't beat yourself up.

When we feel guilty or deem ourselves worse than we are, we are going to
make bad things happen to us. For example, if you feel angry and put
yourself down because of it, the next time something goes wrong, you will
be angry at yourself for being so stupid. We have all done this for one
reason or another, and it is important not to do it anymore because of the
potential negative effects on our mental health.

* Learn from your mistakes, but don't dwell on them.

It can help to learn from past mistakes and then move on but don't let those
past mistakes destroy your present happiness or work towards the future.
Don't think about how things could have been different because you will
only get upset. Instead, think about how you can do the same thing
differently in the future to work out better for you.

So there you have it; these are some of the best tips for dealing with
anxiety, depression, and anger. It does take some work, but once you get
used to not letting these things affect your life and taking steps to fix them,
they will no longer control your life. Treating these issues is very important
and should always be a top priority because if we don't, they will only
worsen over time. You must talk to someone if you have difficulty dealing
with these emotions. You must open up and share your emotions with the
people around you. If they do not understand what you are talking about,
find another person that can help. There are many places to get help with
emotional issues so don't be afraid to reach out and grab that life-saving
help that could be right in front of your face. With this new information at
your disposal, I'm sure you will have no problem getting rid of anxiety,
depression, and anger.

There are a lot of people out there who have been victims of emotional
abuse or bullying. It can be devastating to our emotional stability if we don't
know how to deal with it. Knowing how to deal with emotional abuse and
bullying is the only way you can move on and not let it affect the rest of your
life.

One of the best ways to deal with emotional abuse or bullying is to avoid it.
This doesn't mean walking around afraid all day because that will negatively
affect your mental health, but it does mean that you should have an escape
plan in case something happens so that you are not stuck in that situation
for too long.

By having a plan of action or knowing what to do, you are already taking
steps toward dealing with this type of abuse effectively. If you are currently
dealing with emotional abuse or bullying, I recommend you talk to your
parents or teacher about it. You must let someone know what is going on in
case it happens again for some reason. Talking about things like this can
help the problems go away faster because of what you tell them. You will
also get the help you need if they want to give it to you.

After speaking with your parents or teacher (or sometimes both), your next
step is to make sure that they do not allow this type of thing to happen
again and if they know who did it, make sure that s/he is being punished for
doing so. If your parents or teacher do not do something about it and you
feel like nothing is changing, you can always go to a different adult that you
know would be able to help you.

Another step toward dealing with emotional abuse or bullying is to avoid the
person doing it if possible. If they are just bullying you in school, try sitting
away from them, standing where they can't get to you easily, or even sitting
with another friend. These steps will keep them from bothering you; this
way, they don't have any power over what happens to you anymore.

If the emotional abuse or bullying continues, talk with someone after school
instead of going straight home, so the bully doesn't see what happens to you
afterward.

How to overcome fear through self-management techniques.

Overcoming your fear is not easy – it takes the right set of skills. This is
where emotional self-management comes in. This technique takes some
time to master, but the benefits can be huge.

If I could give one tip for managing your emotions, it would be to try putting
yourself in a positive space every day. Maintenance work like this can help
keep negative thoughts at bay so that they don't consume your whole day!
Plus, finding happiness in the little things makes coping with other
obstacles a lot easier when they come along.
Self-management techniques can be used for anything that affects your
emotions.

One of the most common benefits of emotional self-management is learning

to ignore negative thoughts and turning them into part of your positive
routine.

Therefore, these tips can enable you to overcome fear through self-
management techniques:

1. Identify the source of your fear and talk to it

The best way to overcome your fear is to know what it is. Start by
identifying what your fears are the most. Identifying your fear will enable
you to find ways to manage them.

2. Identify sources of support

A good way to overcome fear through self-management techniques is to

identify your sources of support. You can find sources of support in your
family, friends, and other people you trust. Surrounding yourself with
people that care about you will help you overcome fear through self-
management techniques.

3. Get rid of negativity

Because fear is a negative emotion, an effective way to overcome fear

through self-management techniques is to get rid of negativity in your life.
Being around negative people or things that bring you down will only lead
to more fear. You need to find methods for getting your mind off of
whatever is causing your fear that you can practice every day.

4. Remove any safety measures

Part of overcoming your fear through self-management techniques is taking

away any safety measures you have put in place because of the fear. If you
have a phobia of spiders, talking yourself into confronting one won't work
unless you are willing to do so without safety measures like running away or
calling other people for help.

5. Face your fears

The best way to overcome your fear is to face them. This can be done by
confronting the object of your fear, telling yourself that you will no longer
be afraid of it, and not letting yourself retreat into fear due to the
discomfort that this causes.

6. Focus on the positive aspects of things

A good way to overcome fear through self-management techniques is

simple: just look at things that you are curious about and think only positive
thoughts about them. If you're curious about snakes, don't think about what
will happen if one bites you; just think about how cool they are. Ending up
in the ER will not likely make you less fearful of snakes!

7. Think of the worst-case scenario

Remember that the worst-case scenario is not always as bad as you think.
The next time you are afraid of something, think about what will happen if
your fear is realized. Chances are, it's not going to be as bad as you think; if
it is, there may be a way around it or someone who can lend a hand.

8. Change your perspective

One of the best ways to overcome fear through self-management techniques

is to change your perspective. It's natural for the mind to focus on the worst
possible outcomes of a situation, but you can't change what happens in
reality by focusing on it.

9. Don't let fear dictate your life

Fear can take over a person's life if they let it, so don't let that happen to
you! If one of your fears keeps you from doing something you want to do,
make sure that there is another way around it or find a way to remove that
fear entirely.

10. Focus on the present

One of the best ways to overcome fear through self-management techniques

is to focus on what is currently happening. Doing this will take your mind off
whatever could go wrong in the future. You may be afraid of flying, but
instead of dwelling on the past or worrying about a potential future flight,
just focus on your current situation.
11. Think about something that you can control

Another great tip for overcoming fear through self-management techniques

is to focus on something you can control in front of you – your hands or feet,
for instance. Focusing on something you can control will help your mind
focus on positive things rather than the fear you are feeling.

12. Don't waste your energy thinking about things you can't control

One of the best ways to overcome fear through self-management techniques

is not wasting your energy worrying about things you have no control over.
It's highly unlikely that worrying about something your boss might say will
make them like you more, so don't waste your energy thinking about it.

13. Keep doing what makes you happy

A good way to overcome fear through self-management techniques is to

keep doing things that make you happy – even if it's something as simple as
watching funny cat videos online.

14. Put your fears in perspective

A great way to overcome fear through self-management techniques is to put

your fears in perspective. Think about what you have sacrificed because of
your fear and whether or not it was worth it. If it wasn't, confront that fear
the next time you have the opportunity.

15. Use positive self-talk

Another great way to overcome fear through self-management techniques is

to use positive self-talk when facing a tough situation or a fear that keeps
you from doing something you want to do. Tell yourself that you can do this,
and if things don't work out right away, just keep trying until they do.

16. Make plans for the future

You may think that your worst fear is bugging you right now, but what if it's
not? What if your fear is something that is happening in the future? Making
plans for the future can help build up positive expectations and make you
less afraid of things that will happen.

17. Don't focus on negative events in your life

If you're focusing too much on bad things that have happened in your life,
relive those memories and spend all of your time worrying about them
instead of making new memories that are more positive. Instead, focus on
the future and the things that you want to do.

18. Look at the bright side of things

Using positive self-talk is another great way to overcome fear through self-
management techniques, but there's no reason why you can't take this idea
one step further and look at the bright side of everything. Even if something
bad happened in the past, there's a good chance it won't happen again.

19. Imagine what you're afraid of

If you fear something like public speaking, for example, imagine yourself in
the situation. If your fear is that bad, you will find that your fear does not
come true, even though your imagination may have gone into overdrive.

20. Practice!

Practice makes perfect! Remember learning to ride a bike? Now, how many
of you are nervous when riding a bike now? The more you do something
that makes you afraid, the less frightening it becomes. So practice
everything from public speaking to your favorite sport if it helps to make it
less stressful.

21. Don't make it a big deal

One of the best ways to overcome fear through self-management techniques

is to pretend nothing is wrong. If someone is afraid of something, smile and
say, "Hey! You don't have to be afraid of that – I'm here with you!". This
way, you can encourage your friend that there's nothing to worry about.

22. Take deep breaths

Deep breaths are the perfect way to keep yourself from panicking and
showing any signs of stress when facing a tough situation. Deep breathing
has numerous health benefits, including long-term stress reduction.

How to rewire your mind to experience the benefits of a more

positive and emotionally-stable life.
For most people, negative thoughts run rampant - and that's not a good
thing. We've created a list of the most popular online websites where you
can find like-minded folks who are working diligently to break free from
these negative patterns in their lives.

The majority of us would have become resigned to – and oftentimes even

comfortable with – our negative thoughts. Many of us allow them to drive
our every waking moment and are rarely surprised by their influence. The
result is that we spend most of our lives feeling frustrated, sad, angry, or
disappointed.

Rewinding your mind to a more positive slant can be an arduous and often
challenging process. But it's a process that can be very rewarding and is
essential for anyone wishing to live a more balanced, present, and happy
life.

There are many jargons used today – such as mindfulness, self-help, and
New Age techniques – but what they all have in common is a focus on the
mind or your ability to change it. This book will take you through some of
the many systems and techniques that have been developed over the past
few decades to do just that.

There are many different ways to live a more balanced and present life, but
here's a great starting point for anyone looking for ways to change their
mindset.

Mindfulness and Mindfulness-Based Cognitive Therapy: The practice of

mindfulness is simply being aware of one's current thoughts and feelings,
including any painful emotions while not judging them as good or bad. It is
accepting your experiences and observing them with non-judgmental
awareness – thereby creating an inner space that is calm and stable.

The practice of mindfulness has been shown to help reduce stress, anxiety,
and depression. It also helps control impulsiveness and negative emotions –
such as anger, hatred, resentment, and fear – which cause many problems
in our lives.
One of the most popular programs for mindfulness is Mindfulness-Based
Cognitive Therapy (MBCT). It combines cognitive therapy and mindfulness
training to assist people who are at risk of relapse during times of stress.

While there are many other ways to learn about mindfulness and MBCT,
these websites offer a good starting point for anyone wishing to learn more:

The benefits of learning MBCT include the ability to cope with daily
stresses, live in the present moment, and let go of negative emotions such
as fear, anxiety, and depression.

Self-Awareness: Being self-aware is a very important skill that can be

learned through various techniques used by psychologists. Self-awareness is
knowing yourself, understanding yourself, and accepting yourself. We all
have things that make us unique and interesting – but it is the difference
between being aware of them and being self-absorbed.

Self-awareness can be directly related to improving your life. This skill

allows you to understand your emotions and give you a chance to achieve
more in life by taking into consideration what makes you happy.

The benefits of learning how to be more self-aware include creating a better

understanding and appreciation for all of your experiences. This, in turn,
allows you to live a more balanced life and make better decisions.

As the saying goes – knowledge is power, but freedom is mightier still. This
is especially true when it comes to living a happy, balanced, and present life
– which can only be achieved by using many different tools and techniques.
Due to the nature of these tools, they can often help provide you with
freedom from the mental prisons that you find yourself locked in on a daily
basis.

Freedom from the many negative emotions that you experience on a regular
basis.

To use our previous example – freedom from thinking about the past and
future. Many of us spend a huge portion of our lives thinking about things
that haven't even happened yet – while ignoring what's going on right now.

Learning how to be more self-aware and live in the present moment can be
challenging, but it's also one of the most liberating things you'll ever do.
Access Consciousness: Access Consciousness is yet another method used to
get in touch with your inner self and gain more control over your life and
happiness.

Like many other philosophies and techniques, this system holds that you
can change your life by changing your underlying beliefs. And it works
within the premise that you are already perfect in every way, but that you
often don't realize it.

So how do you access your inner self? You don't train yourself to be
conscious – you train your unconscious mind to become conscious through
the use of autosuggestion, visualization, affirmation, and self-hypnosis.

This process is designed to allow you to create a new level of awareness in

yourself with the help of specially trained coaches. This, in turn, allows you
to gain more control over your life and your emotions.

The techniques involved in accessing consciousness are very similar to

those used for traditional alternative therapy; however, it also includes
modern techniques that have been developed by psychologists over the past
50 years or so.

This is a great resource for anyone interested in learning more about this
system:

The benefits of accessing consciousness include being able to:

• Separate yourself from your emotions and control the situations you find
yourself in.

• Understand what you want and what you don't want in your life.

• Create specific goals for yourself that will make you happy.

• Become mentally stronger and happier.

We all have the power to change our lives – by changing the way we
perceive the world around us. In some cases, this may require a different
approach than using traditional therapy – but if it works, it can be very
rewarding in the long run.
Emotions or Emotional Freedom Techniques: These techniques are based
on the principles of hypnosis, but are different from other systems because
they don't involve any kind of traditional training. They work by opening up
a mental and emotional channel for you to release your feelings.

This process is effective in allowing you to let go of unwanted emotions and

move on with your life.

With emotions, you're not going to experience any kind of trance-like state –
but it still allows you to gain access to your unconscious mind which can
help create a new mindset – one that's more aware and happier.

It also helps in eliminating some negative emotions such as anxiety and

depression caused by past experiences.

The next chapter will discuss Frequently Asked Questions. These questions
cover a variety of topics that are important to understand when considering
the use of alternative therapy and self-help methods. Moreover, they will
also answer many of the most common questions that people ask.
Therefore, the chapter will cover a variety of questions that commonly arise
when considering the use of alternative therapy methods.
 FAQ
Q: How will these therapies help me or my patients?

A: With the tried-and-true listening skills, deep empathy, and strong focus
on safety and trust, these therapies are perfect for patients who may
require a helping hand to recover from trauma from their past or who have
a difficult time expressing themselves verbally.

Q: Is this good for beginners?

A: Definitely! The highly-trained therapists behind these programs are

experts in their field and provide an extremely gentle and supportive
introduction to hypnosis and NLP. Often, patients find that these
introductory sessions are enough to provide a lasting positive impact on the
issues that brought them in the door.

Q: Why are these therapies different from other treatments?

A: This series of programs offers the real, tangible help you need to make
positive changes in your life, no matter what the issue. Whether it's
managing pain and stress, overcoming negative habits or emotions,
changing unhelpful perceptions and reactions, or building rapport with
other people, these therapies will provide you with the tools to do it all.
 CONCLUSION
The vagal nerve communicates with the brain stem, which controls the
heart and lungs, and can thus decrease heart rate. It also connects to
various other organs in the body. Essentially, it influences every part of your
body so that you can focus on what's happening in your mind.

Several therapies reverse many mental issues by using the vagus nerve to
create a new connection between parts of the brain - like when your
smartphone connects to a wireless network. In this case, not only is there
no need for drugs or surgery, but it could be an improvement on traditional
therapies.

This will come as a surprise to many, but it was thought that the vagus
nerve led to brain death for a long time. However, there is no evidence that
this is the case, and these days, you can have many operations with barely
any pain and return to normal life. In addition, your well-being will improve
significantly.

Nevertheless, a lot of people are still unaware of these breakthroughs. In

fact, in the past few years, many new studies and medical reports have
shown just how safe and effective this nerve therapy is. So, whether you are
an individual or a representative of the medical field, you can learn much
from this information.

These medications are available in most pharmacies, and they work by

creating new fibers in the brain through an electrical current passing
through it. Normally they break down fiber signals before they can pass
through brain cells, but this new way of operating increases them over time
so that they can stay alive longer without their fibers breaking down.

CBT is the most effective therapy used to reverse abnormal brain signals in
people who develop dementia. The treatment for this condition involves
sending an electrical current through the vagus nerve to the brain stem,
which is located at the base of the skull. Through electrical impulses, this
new method works on communication between different parts of the brain
and effectively reverses negative thoughts or actions.
DBT is a less invasive approach than CBT and sends direct impulses into
your abdominal region. However, it still sends electrical signals through the
vagus nerve to create new connections between different parts of your body
and mind. This therapy works especially well on mood disorders, including
depression and addiction.

ACT is a treatment that involves creating new neural pathways in the brain.
Essentially, you can use breathing techniques along with muscle exercises
to stimulate your vagus nerve. The best part of this method is that it's
completely non-invasive, so there aren't any drugs or surgery involved.
Instead, you can send signals directly to your brain to help you relax and
clear your mind.

HSE uses an electrical current to stimulate your vagus nerve for

therapeutic use. An implanted stimulator sends signals through the nerve so
that they can pass through your body and stimulate different brain areas.
For example, an implant in the ear could help with pain management, while
one in the neck could serve as a form of treatment for depression or post-
traumatic stress disorder. Essentially, this method works to treat a variety
of conditions, including anxiety and even weight loss or smoking cessation.

When you begin working on treating any mental health-related issues, it's
important to know just what type of therapy is best for you. For example, if
you have chronic depression, you could opt for vagus nerve therapy to get
better sleep and feel more positive about your life. Another option for
depression is VNS Therapy which involves sending electrical impulses
through the nerve to control your brain and heart.

While the vagus nerve is used mostly nowadays to treat pain, it's also
commonly used to treat heart conditions by slowing down the heart rate.
This method is called a VNS pacemaker or implant, and it works by creating
a new neural pathway between your body and mind. Essentially, this
treatment can help patients with issues like migraines or those who've had
a stroke by stimulating their vagus nerve to regulate their heartbeat.

HSE helps reverse chronic pain by sending electrical currents through the
vagus nerve, which connects to the same brain area where a migraine
originates. This treatment is performed on an outpatient basis and has few
side effects, unlike many other therapies.

Ultimately, all of these approaches help to create new connections between

parts of your body and mind, which are created through electrical currents
passing through your vagus nerve. The more you use this method, the
better you'll feel, so be sure to spread this information and continue your
research.

Highly Sensitive Empaths have both heart and head wired together,
whereas others mostly have heads wired to the heart.

The result is that Highly Sensitive Empaths can feel what others feel.
Another word for this is "high empathy." But what is empathy? Empathy is
the ability to understand others' feelings and emotions, and it turns out that
Highly Sensitive Empaths are very good at it. So much so that they often
find themselves overwhelmed by other people's feelings.

Most empaths go through a stage of suffering because they experience too

much of how others feel (and think). And for some empaths, this suffering
mostly comes from thinking about other people's feelings. Suffering from
too much of someone else's emotion is called "transference."

Empaths undergo a period of Transference when they suffer because of

other people's emotions. Empathy is a process that happens in healthy
empaths and empaths suffering from too much transference. If you are an
empath, you can learn how your brain works and take steps to stop being
overwhelmed by other people's feelings.

Some suggest a two-step process of understanding another person's

feelings – firstly, you need to understand that they feel what they feel (high
empathy/high empathy).

Therefore, these therapies can be used to help you develop your natural
healing energy. The feeling of extra energy is called "heart energy," It
creates a connection between your heart and mind, like when someone has
the privilege of connecting to a wireless internet network.

Highly Sensitive Empaths, or HSE, are people who are very sensitive to all
types of things. This can be compared to being wired in two different ways.
If you compare this with others who have "more head wiring," one way is
that they can feel what others feel (high empathy). The other is that they
are very sensitive (head wired) to situations and events.

Highly Sensitive Empaths, or HSE, are extremely sensitive and can easily
pick up on other people's feelings (emotions, thoughts, and intentions).

This is why most empaths suffer from being overwhelmed by other people's
emotions. This happens because an empath has both heart and head wired
together.

The result of this is that empaths can feel what others feel - this is called
being sensitive. Another word for this is "high empathy." But what is
empathy? Empathy is the ability to understand others' feelings and
emotions. It turns out that Highly Sensitive Empaths are very good at it. So
much so that they often find themselves overwhelmed by other people's
feelings.