Step 1.
Assess your emotional state: The Burns Depression Checklist
Scores 11 - 50 schedule an appointment with your doctor to discuss your feelings and an appropriate way forward for you.
Scores over 50 go straight to your closest hospital, doctors surgery or walk in clinic and state that you are in crisis and need to be seen straight away.
Step 2.
In conjunction with advice from your doctor, and using the destructive thoughts sheets found here, follow the instructions below (do this daily for every destructive thought you have):
"Write down any negative thoughts about [yourself], your body [or your situation]. Now identify the cognitive distortions [thinking errors] behind them from the list below. Next, write down a rational thought to replace each negative thought. And remember, this technique has a far more profound effect if you actually write these thoughts down.
The mental filter [distortion/ thinking error]
This is when we focus on one negative aspect of ourselves, dwelling on it to the exclusion of all else.
Example: ‘I won’t be able to enjoy my holiday because my stomach is so fat.’
Rationalisation [alternative thought]: ‘There are plenty of things about my body that I really like. Why not focus on them instead?’
Example: ‘I won’t be able to enjoy my holiday because my stomach is so fat.’
Rationalisation [alternative thought]: ‘There are plenty of things about my body that I really like. Why not focus on them instead?’
All-or-nothing thinking
This is the kind of thinking that lays the foundation for perfectionism. If we can’t reach our unrealistic expectations we give up and do nothing at all.
Example: ‘If I don’t lose a stone before going on holiday, I might as well forget eating healthily, and start binging again.’
Rationalisation: ‘I’m eating well and feel much healthier. There’s no point trying to lose a stone in a fortnight. It’s enough to eat a little more healthily so my energy levels rise before I go away.’
This is the kind of thinking that lays the foundation for perfectionism. If we can’t reach our unrealistic expectations we give up and do nothing at all.
Example: ‘If I don’t lose a stone before going on holiday, I might as well forget eating healthily, and start binging again.’
Rationalisation: ‘I’m eating well and feel much healthier. There’s no point trying to lose a stone in a fortnight. It’s enough to eat a little more healthily so my energy levels rise before I go away.’
Disqualifying the positive
What happens when we dismiss the positive and automatically discount people’s compliments and positive reactions towards us.
Example: ‘He doesn’t really like my body; he’s just pretending.’
Rationalisation: ‘He says he likes my body, and has no reason to lie. The simplest explanation is probably the most correct – that he’s actually telling the truth.’
What happens when we dismiss the positive and automatically discount people’s compliments and positive reactions towards us.
Example: ‘He doesn’t really like my body; he’s just pretending.’
Rationalisation: ‘He says he likes my body, and has no reason to lie. The simplest explanation is probably the most correct – that he’s actually telling the truth.’
Fortune telling
Without any evidence, we anticipate that something’s going to happen, and then we act and feel as if it had already happened. We’ll also ‘mind-read’, jumping to negative conclusions about what people are thinking about us.
Example: ‘When I get on the beach, everyone’s going to look at me and think I’m enormous.’
Rationalisation: ‘Actually, no one will be looking at me; they’ll be far too busy thinking about themselves.’
Without any evidence, we anticipate that something’s going to happen, and then we act and feel as if it had already happened. We’ll also ‘mind-read’, jumping to negative conclusions about what people are thinking about us.
Example: ‘When I get on the beach, everyone’s going to look at me and think I’m enormous.’
Rationalisation: ‘Actually, no one will be looking at me; they’ll be far too busy thinking about themselves.’
‘Should’ statements
When our reality falls short of the very high standards we set for ourselves we can get upset and berate ourselves for not living up to our ideals.
Example: ‘I should be ultra-thin for summer.’
Rationalisation: ‘There is no real reason I should be so incredibly thin for summer. It’s far more realistic and kinder to myself to want my body to be healthy and active instead.’
When our reality falls short of the very high standards we set for ourselves we can get upset and berate ourselves for not living up to our ideals.
Example: ‘I should be ultra-thin for summer.’
Rationalisation: ‘There is no real reason I should be so incredibly thin for summer. It’s far more realistic and kinder to myself to want my body to be healthy and active instead.’
Labelling and mislabelling
Instead of describing a situation objectively, we give negative labels to ourselves, which makes us feel worse.
Example: ‘I look like a beached whale.’
Rationalisation: ‘I’m clearly not a beached whale. That’s a particularly unpleasant thing to call myself, and I wouldn’t dream of saying something like this to anyone else.’
For more CBT techniques, read Feeling Good: The New Mood Therapy by Dr David Burns."Instead of describing a situation objectively, we give negative labels to ourselves, which makes us feel worse.
Example: ‘I look like a beached whale.’
Rationalisation: ‘I’m clearly not a beached whale. That’s a particularly unpleasant thing to call myself, and I wouldn’t dream of saying something like this to anyone else.’
Article from Psychologies.co.uk
Step 3.
Keep a small notebook with you at all times. Write in this note book all the good things people have said to you or done for you no matter how big or small. At the end of each day, read every single entry from start to finish. Start to feel human again…
Step 4.
Setting Goals
Identifying life goals is the heart of the recovery process. When we see a future for ourselves, we begin to become motivated to do all we can to reach that future. Goals can be big or small, depending on where you are in your recovery journey.
Ask yourself:
What motivates me?
What interests me?
What would I do more if I could?
What do I want?
What do I care about, or what did I care about before my illness?
Where do I want my life to go?
What brings me joy?
What are my dreams and hopes?
It can help to start small and work up to larger goals. You might want to begin by setting one small goal for yourself at the beginning of each day. As you move forward with your recovery, look at the different areas of your life and think about your short and long term goals.
Short term goals might include:
Be out of bed by xx:00 am.
Finish one household chore.
Call a support group.
Long term goals might include:
Get training or experience for a job.
Change a living situation, e.g., find an apartment
Build a relationship with a friend or family member.
Remember break your goals down into small steps at first. Looking at a goal such as 'move to a new city' can be difficult to visualize and plan all at once. Ask yourself what you need to do first. What can you do now that will help you eventually reach this goal? Not only will this help move you closer to your goal, but it will also help give you a positive feeling of accomplishment.
Further Help: http://www.rcpsych.ac.uk/mentalhealthinfoforall.aspx
Other useful resources at the footer of this blog.
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