Toronto Therapist and Counsellor Greg Dorter

Positive Psychology, Blessings and Gratitude

Greg — Tue, 08 Nov 2011 00:29:50 +0000

Have you ever felt anxious and noticed yourself being extra vigilant, looking for any signs that something bad may be lurking nearby, on the lookout for all the things you might need to worry about?

This may seem like a good way to protect yourself from the things you’re anxious about, but it usually backfires. Since there is never any end to the list of “what ifs?” you can find to worry about, if you’re constantly looking out for things that could go wrong, you’ll usually find them, and this keeps you in a state of worry and anxiety.

Or have you ever been depressed, and found yourself focused on all of the negative things in your life, trying to figure out how they happened and how to
solve them? Again, this sounds like a good way to fix what’s wrong in your life, but it often ends up making things worse. You keep finding more and more things to regret, more disappointments, more ways you don’t measure up to other people, and it’s easy to get overwhelmed by all the negatives that keep adding up.

The more we’re on the lookout for something, the more likely we are to find it. But just as it is easy to find things to worry about or feel badly about when that’s what we’re focused on, it’s also easy to find some things to feel good about when that’s what we’re looking for and paying attention to.

Lately, a type of therapy called Positive Psychology, has been gaining popularity as research continues to demonstrate the effectiveness of positive psychology in helping people feel better and increase their well-being. Compared to many other approaches to therapy, positive psychology focuses less on identifying and fixing deficits, and more on recognizing and building on positives—looking at “What’s right with you?” instead of “What’s wrong with you?”

In his book Flourish: A Visionary New Understanding of Happiness and Well-Being, Martin Seligman writes:

We think too much about what goes wrong and not enough about what goes right in our lives. Of course, sometimes it makes sense to analyze bad events so that we can learn from them and avoid them in the future. However, people tend to spend more time thinking about what is bad in life than is helpful. Worse, this focus on negative events sets us up for anxiety and depression. One way to keep this from happening is to get better at thinking about and savoring what went well.

Seligman, who is one of the founders of positive psychology, has developed an exercise I often use with clients who in are experiencing depression or anxiety, and very focused on negative things in their lives. The exercise is called “Three Good Things,” or “Three Blessings,” and even if you’re not feeling depressed or anxious, it can help you appreciate the goods things in your life.

In the two videos below, Seligman talks about this exercise, and there are written instructions following the videos.

The instructions are quite simple. Every night for a week:

Set aside 10 minutes after dinner and before you go to bed
Write down three things that went well today
Next to each positive event answer the question why did this happen.

The three things can be relatively small in importance, such as “I saw a beautiful sunset,” “I woke up a few minutes early and didn’t have to rush to get out of the house,” or “A stranger held a door open for me when my hands were full with grocery bags.” Or even something like, “Instead of spending all day lying in bed feeling depressed I got up in the afternoon and went outside for a few minutes.” Of course, they can be more significant events, like “I got a new job,” or “My partner and I moved in together.” But those monumental events don’t come around every day.

Once you start looking for positive things that happen in your life, you can usually find at least three small things that went well every day, and start enjoying some benefits of positive psychology. Researchers have found that this simple exercise increases happiness and decreases symptoms of depression for up to six months, and that many people find the exercise so helpful they continue with it after the one-week period is up.

The gratitude journal is a similar tool we use in positive psychology: noticing the things that happen throughout your day, no matter how small, for which you are grateful, and keeping track of them in a gratitude journal. You can read more about gratitude in positive psychology and the benefits of keeping a gratitude journal in this interview with Robert Emmons, author of Thanks: How the New Science of Gratitude Can Make You Happier.

Emmons cites research that finds:

First, the practice of gratitude can increase happiness levels by around 25%. Second, this is not hard to achieve—a few hours writing a gratitude journal over 3 weeks can create an effect that lasts 6 months if not more. Third, that cultivating gratitude brings other health effects, such as longer and better quality sleep time.

Exercises like Three Good Things and the gratitude journal do more than just allow us to reflect on the positive things that happen. They help us to shift our perspective from focusing on the problems and negative things we encounter throughout our day, to looking for and noticing the positive things that we experience every day.

As a result, once we start looking for things that are going well and that we are grateful for, we find more of them and notice them more often. And when we become more aware of the good things that are happening in our lives and the things we are grateful for, we experience less anxiety and depression, more positive emotions, and increase our happiness and well-being.

I’m a Toronto therapist specializing in counselling and therapy for depression, anxiety, stress and low self-esteem. For more information about how I can help you use positive psychology to increase your well-being, or to make an appointment for counselling or therapy, please call me at 416-516-6024 or email greg@gregdorter.com.

Bringing Mindfulness into your Daily Life

Greg — Wed, 17 Aug 2011 17:18:24 +0000

Mindfulness isn’t just something we practice when meditating: anything we do throughout the day, we can learn to do mindfully. Once we learn to bring mindfulness into our everyday lives, we can reduce a lot of the stress, anxiety, depression and anger that tends to build up when we go through life relatively mindlessly.

It would be great if we could go about our whole day completely mindful, bringing our full attention to whatever we’re doing, while we’re doing it, and not getting carried away by distractions or thoughts of the past or about the future. But although mindfulness sounds simple, it does require effort. It takes a continual effort to notice when our mind’s started to wander and keep bringing it back to the present, and it’s not something most of us can do all day long.

So instead of striving go about the entire day mindfully, it’s good to start with some small steps, and find ways to gradually add more mindfulness into your activities throughout the day. Below are some ways you can start bringing mindfulness into your days on a regular basis.

Choose One Routine Activity to Do Mindfully Every Day

In a previous post, we looked at how you can start being more mindful throughout the day by: a) doing on thing at a time; and b) paying attention to your senses while you’re doing it.

For example, you can take a shower mindfully, by feeling the water hitting your skin; listening to the sound of the water; smelling the scent of the soap or the shampoo; feeling the sensations of lathering soap onto your skin or massaging shampoo into your hair.

Or you can eat a meal with mindfulness, savouring the tastes and aromas; consciously chewing every bite; feeling the sensations of the food against your tongue, noticing when you’re about to swallow, and then swallowing intentionally, and feeling the food move down the back of your mouth and into your esophagus. Noticing any sensations of hunger, or anticipation and watering of your, or of feeling full.

Each day for the next week, choose one routing activity, be it showering, driving to work, cooking, eating, cleaning, etc, do only that one thing at a time, and be as mindful as you can the whole time you’re doing it.

Mindfulness Bells

Thích Nhất Hạnh, a Vietnamese Zen master who has been instrumental in bring more awareness about mindfulness practice to the West describes the practice of using mindfulness bells.

In my tradition, we use the temple bells to remind us to come back to the present moment. Every time we hear the bell, we stop talking, stop our thinking, and return to ourselves, breathing in and out, and smiling. Whatever we are doing, we pause for a moment and just enjoy our breathing. Sometimes we also recite this verse:

Listen, listen.
This wonderful sound brings me back to my true self.

But this practice doesn’t have to be limited to temple bells. He suggests we can use things like the ringing of our telephone, the cry of a baby, the honking of a horn, the bell on an elevator, or even the sound of fire engines and ambulances as our bells of mindfulness.

When we hear the sound, we stop talking and stop moving. We relax our body and become aware of our breathing. With just three conscious breaths we can release the tensions in our body and mind and return to a cool, clear state of being.

Any sound we hear throughout the day can act as a mindfulness bell calling us back to the present.

Sprinkle Moments of Mindfulness Throughout Your Day

In earlier posts, we’ve looked at a few ways to take quick breaks throughout your day to relax and stop stress and anxiety from accumulating, give yourself a time out, or take a 3-minute breathing space. Often when we’re feeling stressed, we don’t have the luxury of stopping what we’re doing for a few minutes and going off by ourselves to rejuvenate. But even at these times, we can find moments to practice mindfulness.

Mindfulness can be as simple as coming back to the present, and paying attention as you mindfully open a door on you way in or out of a room instead of just rushing through the door. Or to take a few breaths while waiting at a red light instead of cursing the traffic and how you’re missing every light. Or pausing for a moment as you turn on or off a light or your computer. Or walking mindfully from your desk to the restroom, noticing the sights and sounds around you, and the feeling of your feet touching and leaving the floor. There are endless ways we can find to be mindful for a few moments, instead of plowing ahead mindlessly from one thing to another all day long.

Here is a handout from the UCSF Osher Center with tips to help you integrate mindfulness into your daily life. There are examples of daily activities to do mindfully, mindfulness bells, and moments of mindfulness.

As you learn to weave these periods of mindfulness into your day, you’ll find yourself approaching more of your day mindfully, and that mindfulness starts coming more naturally. And by taking the time to practice mindfulness throughout your day, you’ll find yourself better able to avoid the pitfalls of mindlessness that can cause such stress, and lead to anxiety, depression and anger. It can be easier than you think. These days you can even practice mindfulness from your computer or smartphone.

I’m a Toronto therapist and counsellor who uses mindfulness in therapy to help people deal with issues such as stress and anxiety.

For more information about how you could benefit from mindfulness-based therapy, visit my mindfulness therapy webpage. To make an appointment for counselling or therapy in Toronto, please call me at 416-516-6024 or email greg@gregdorter.com.

Mindfulness in Everyday Life

Greg — Fri, 12 Aug 2011 16:29:25 +0000

In previous posts, we looked at the importance of giving ourselves time outs, as well as other techniques to manage stress and anxiety. Another great way we can keep things like stress, anxiety and depression from building throughout the day is to start bringing mindfulness into our everyday life.

We often talk about two broad categories of mindfulness practice. Formal mindfulness involves setting aside some time specifically for practicing mindfulness as we do when we engage in mindfulness meditation. Informal mindfulness, on the other hand, refers to finding ways to incorporate mindfulness into our daily lives.

Since mindfulness simply involves paying attention to the present moment, mindfulness can be brought to anything we do. We can take a shower mindfully, shave and brush out teeth mindfully, eat mindfully, walk mindfully, drive mindfully, work on a computer mindfully, talk to people mindfully. Whatever it is we’re doing, we can do it mindfully.

In mindfulness meditation, the focus of our attention is generally our breath. When we incorporate mindfulness into our every day lives, the focus of out attention becomes whatever it is we’re doing in the present moment.

Of course, this is a lot easier said than done. When doing mindfulness meditation, we create a quite, controlled environment, conducive to being able to focus only on our breathing. Yet our minds still get easily distracted and we continually have to consciously return our attention to what we are doing: just sitting and breathing.

In the real world, it can be even more challenging to stay focused on what we are doing in the present, because we face many more distractions. Compared to a quite meditation space, there is so much more going on around us. Our senses are constantly bombarded. We’re often surrounded by other people we have to deal with. We have places to be and things to do and deadlines to meet.

We also have so many disctractions to pull our minds away from what it is we’re actually doing. If we’re doing work, we have email, the internet, our cell phones; if we’re doing housework, we have television and MP3 players; if we’re driving we have the radio and our bluetooth phones. While it’s true that whatever we’re doing, we can do mindfully, it also true that whatever we do, we can do mindlessly. More often than not we find ourselves falling into the mindlessly camp.

But despite all these challenges, there are a few things we can do to help us stay in the present and go about our days more mindfully.

Step 1: Do One Thing at a Time.

Stop multitasking. Don’t constantly check email and facebook while you’re working. Don’t conduct business on the phone while you’re driving. Don’t blast music while you’re doing the dishes or cleaning the ouse. If you’re eating by yourself, you don’t need to have the televsision on or be on your computer.

One reason we try to do so many things at once is that we’re often so busy, it seems like it’s the only way to get everything done. Fortunately, research shows that when we attempt to do two things at once we are not as effective at either one, and both tasks will take longer to accomplish than if we were to focus on one activity at a time. This means we needn’t feel pressure to multi-task to in order to be more efficient.

Another reason we don’t like to do just one thing at a time is that we think we’ll get bored. Most of the things we do through the day aren’t that difficult, and they don’t require a lot of attention or concentration. We don’t need to put a lot of thought into how to wash the dishes. Or focus a lot of attention on driving the same route we take every day.

Since most of these activities don’t take a lot of brain power, it leavces a lot of empty space in our mind. So we fill this space with the television, the radio, the internet, conversations in our head, or worse, we spend the time worrying or ruminating and making ourselves stressed, anxious or feeling depressed.

Step 2: Pay Attention to Your Senses

The most effective way to bring mindfulness into these seemingly mindless activities is to start paying attention to our senses. Instead of just trying to get through menial things as quickly as possible, become mindful of what you’re experiencing through your senses: what you’re hearing, seeing, smelling, touching and tasting. Approached with mindfullness of our sensory experience, we can find all sorts of pleasure and interest in these activities.

Instead of going through most of our lives with our experiences clouded by a haze of thoughts, daydreams, worries, and distractions, mindfulness helps us connect to our lives in the present. Mindfulness allows us to find contentment, wonder and even joy in even the simplest things.

For example, if you’re taking a shower, you don’t need to pay much attention to the mechanics of washing yourself. So instead of letting your mind get carried away with other things, pay attention to the sensations you’re experiencing. Feel the water hitting your skin. Listen to the sound of the water. Smell the scent of the soap or the shampoo. Feel the sensations of lathering the soap on your skin or massaging the shampoo into your hair. Once we start tuning into our senses, things like taking a shower no longer seem so boring.

You can do the same thing while eating a meal. How often have you looked forward to a delicious meal, only to deprive yourself of the chance to enjoy the taste, the smaell, the texture of the food because you’re too busy watching TV or surfing the internet to be mindful of what you’re eating.

In the next post, we’ll look at some simple ways you can start incorporating more mindfulness into your daily life.

I’m a Toronto therapist and counsellor drawing from mindfulness-based approaches to therapy to help people overcome issues such as depression, anxiety, stress and low self-esteem.

More About Cognitive Behavioural Therapy (CBT) and Cognitve Therapy

Greg — Tue, 09 Aug 2011 21:45:53 +0000

On the main part of my webpage, I describe cognitive behavioural therapy (CBT), or cognitive therapy, as a type of therapy that focuses on the relationships and connections between our thoughts, feelings and actions. This sounds simple, but what does it mean? In this post, we’ll look at what’s behind cognitive behavioural therapy in a little more detail.

In the CBT/cognitive therapy model, we recognize that we are each affected by the environment in which we live. This environment involves both our current situations (family, friends, job, culture, various stressor and supports, etc.), as well as our past (our family history, past relationships, previous successes and failures, etc.).

Within our environment, there are four elements of ourselves that interact with each other:

Cognitive: thoughts, cognitions, beliefs, self-talk

Behavioural: actions, behaviours

Emotional: feelings, moods, emotions

Physiological: biology, genetics, physical, physiology

These relationships are depicted below:

Notice from the arrows in the above diagram that:

Our thoughts affect our behaviour, our emotions and our physiological state

Our behaviours affect our thoughts, our emotions and our physiological state

Our emotions affect our thoughts, our behaviours and our physiological state

Our physiological state affects our thoughts, our feelings and our behaviours

In cognitive behavioural therapy, we recognize that various factors from the past may contribute to the development of the issues you’re dealing with, but the emphasis is on the present. Rather than focusing on your past, in CBT/cognitive therapy, we’re primarily concerned with determining what is maintaining any distress or symptoms you’re currently experiencing, and what changes you can make to start feeling better.

Because our thoughts, our feelings, our actions and our physiological responses are so closely linked, making changes in any one of these areas tends to bring about changes in the others. There are some examples of how these elements interact with each other in my posts on The Vicious Cycle of Depression and The Vicious Cycle of Anxiety.

Some of the ways we make changes involving these four areas in cognitive behavioural therapy are:

Cognitive

Identifying and re-evaluating negative thoughts, beliefs and patterns of thinking

Learning more effective problem-solving and decision-making strategies

Using mindfulness to deal with “uncontrollable” and racing thoughts, allowing you to let go of unnecessary thoughts without getting caught up in them

Behavioural

Changing unhelpful behaviours such as social isolation, avoiding situations, procrastination and inactivity

Learning to be more assertive and communicate more effectively

Pursuing pleasurable activities and interests that promote happiness and make life more meaningful and fulfilling

Emotional

Learning how to experience and accept negative emotions without becoming overwhelmed

Techniques to transform painful emotions into more manageable feelings

Strategies to help tolerate emotional distress and manage extreme emotional reactions such as intense anger, anxiety or sadness

Physiological

Breathing exercises and relaxation techniques to calm physiological responses and reduce stress levels

Mindfulness practices to cope with stress and physical discomfort or pain

Improving sleep, diet and exercise habits to improve physical well-being

Sometimes CBT is done in conjunction with anti-depressant or anti-anxiety medications prescribed by a physician

For some specific examples of how cognitive therapy and cognitive behavioural therapy work in practice, please see my posts on CBT for Depression and CBT for Anxiety.

I’m a Toronto cognitive behavioural therapist who uses CBT and cognitive therapy to help people overcome depression, anxiety, stress trauma/PTSD and low self-esteem.

For more information about how you could benefit from CBT/cognitive therapy, or to make an appointment for cognitive behavioural therapy in Toronto, please call me at 416-516-6024 or email greg@gregdorter.com.

Give Yourself a Break From Stress, Anxiety and Depression

Greg — Thu, 04 Aug 2011 20:06:47 +0000

In a couple of recent posts, we looked at some things you can do to help stop stress and anxiety from becoming overwhelming, and to give yourself a breathing time out from stress, anxiety and depression. In this post, we’ll look at a couple more techniques you can use to manage stress and anxiety, and to help your emotions from becoming overwhelming if you’re experiencing depression or anger.

The first is called the Three Minute Breathing Space, and it was developed as part of the Mindfulness-Based Cognitive Therapy program for people with depression. Like the Breathing Time Out, it’s a way to bring your attention to the present, give yourself a break from whatever stress or emotions have been building up, and then return to the rest of your day, more refreshed and focused on the present.

Three-Minute Breathing Space

This exercise is a way to step out of “automatic pilot” and bring yourself into the awareness of the present moment.

Awareness

Bringing yourself into the present moment, adopting an alert yet comfortable posture, close your eyes, if this is comfortable and bring your attention inward. Becoming aware of your body and the surface upon which you are sitting, draw your focus to the spine each vertebra stacked upon the other from sacrum to skull.

Now, turning your attention to your thoughts and feelings, ask, “What thoughts and feelings are around right now? What bodily sensations are present? Acknowledge your experience in this moment, even if it is unwanted.

Gathering

Now, gently direct your awareness to your breathing, following each inbreath and each outbreath, one after the other, if necessary, saying to yourself, “I am breathing in. I am breathing out.”

The breath can function as an anchor to bring you into the present moment since the breath is always with us and available at any time as a focus of attention. Regulating the inbreath with the outbreath can assist in maintaining awareness and stillness.

Expanding

Now, expanding your awareness to the whole body, imagine that you are breathing with the body as a whole including your posture and facial expression. When you’re ready, open your eyes and return to your day.

If you’d like to try this exercise along with audio instructions to guide you through it, you can right-click on Three Minute Breathing Space MP3 to save the MP3 file to your computer, or just click on the link and it will play in a new window.

A similar brief mindfulness technique that can help you stay more relaxed, present and focused throughout the day is called The Mindful Check-In. The video below describes this exercise and guides you through it.

Finding ways to give yourself little breaks throughout the day is one of the most effective things you can do to manage stress, anxiety, and feelings of depression or anger.

No matter which technique you choose, giving yourself these brief time outs throughout the day is a great way to stay more mindful and in the present, and avoid getting caught up in stress and anxiety or strong negative emotions related to things like depression and anger.

I’m a Toronto therapist specializing in helping people overcome stress, anxiety, depression, anxiety and low self-esteem. For more information about how I can help you manage stress and anxiety, or to make an appointment for counselling or therapy, please call me at 416-516-6024 or email greg@gregdorter.com.

Give Yourself a Breathing Time Out

Greg — Tue, 02 Aug 2011 14:50:20 +0000

In a recent post we looked at a couple of exercises you can use to help stop stress and anxiety from becoming overwhelming. Another technique you can use throughout the day to manage stress and anxiety, and to help keep strong emotions and feelings of depression and anger from becoming overwhelming, is to give yourself a Breathing Time Out.

Just as a time out can be an effective way to help children calm down when they are acting out and starting to get out of control, when our thoughts and emotions start getting carried away, a time out is a great tool to help calm ourselves.

When we are feeling stress or anxiety, one of the most effective ways to slow things down and become more calm is to practice deep, or “abdominal” breathing. When we are stressed, tense, or anxious, our breathing often becomes more rapid and shallow. Our abdominal muscles may also get tense, interfering with the normal contraction of the diaphragm.

Breathing shallow and rapidly causes anxiety. This pattern of anxiety and shallow “chest breathing” can become a self-perpetuating cycle that in turn creates more stress and anxiety. You can download a handout that describes in detail more about abdominal breathing, its benefits, and how to do it.

A breathing time out is something you can do anytime, anywhere. No matter where you are or what you’re doing, your breath is always there, so you can always use your breath as an anchor to pull yourself back into the present.

The exercise below is one of the simplest ways to give yourself a quick time out from stress, anxiety, and any strong emotions related to things such as depression or anger.

Five Deep Breaths

1. Place one hand on your abdomen right beneath your rib cage. (This is to help ensure you are breathing deeply from your abdomen. Once you are comfortable doing abdominal breathing and can do it naturally, it’s not necessary to still use your hand to guide yourself.)

2. Inhale slowly and deeply through your nose (if possible) into the “bottom” of your lungs—in other words, send the air as low down as you can. If you’re breathing from your abdomen, your hand should actually rise. Your chest should move only slightly while your abdomen expands. (In abdominal breathing, the diaphragm—the muscle that separates the lung cavity from the abdominal cavity-moves downward. In so doing it causes the muscles surrounding the abdominal cavity to push out-ward.)

3. When you’ve taken in a full breath, pause for a moment and then exhale slowly through your nose or mouth, depending on your preference. Be sure to exhale fully. As you exhale, allow your whole body to just let go.

4. Continue breathing like this for 5 breaths, or longer if you want.

This simple time out is something you can give yourself any time you notice yourself starting to feel stressed or overwhelmed. You can do it many times throughout the day to help keep you grounded in the present and not let your mind run off and get caught up in stress and anxiety, or start dwelling in negative thoughts and feelings of depression or anger.

Remember, the key to dealing with stress is to do something about it before it starts to build. A breathing time out is a great tool to help you do this. In the next post, we’ll look at a Three-Minute Breathing Space and Mindful Check-In that you can also use in a similar fashion.

I’m a Toronto therapist specializing in helping people overcome stress, anxiety, depression, stress and low self-esteem. For more information about how I can help you manage stress and anxiety, or to make an appointment for counselling or therapy, please call me at 416-516-6024 or email greg@gregdorter.com.

Breaking the Vicious Cycle of Anxiety

Greg — Thu, 28 Apr 2011 20:54:08 +0000

In a previous post, we looked at the vicious cycle of anxiety, in which an anxiety-provoking events triggers an anxiety-related thought, feeling, behaviour or physiological symptom, which generates additional anxious thoughts, feelings, behaviours and physiological symptoms.

One of the keys to overcoming anxiety is break this cycle before it begins to gain momentum. We often don’t have control of our initial response to an anxiety-provoking situation, but once we become aware that something has triggered an anxiety-related thought, feeling, behaviour or physiological symptom, then we can choose how we react. Mindfulness, and congitive behavioural therapy (CBT) or cognitive therapy, are effective ways to help you stop these cycles before they can build.

Often we respond to our initial anxiety in ways that generate further anxiety-related thoughts, feelings, behaviours or physiological symptoms. This creates a vicious cycle, such as the ones we looked at in an earlier post. However, we can also learn to respond to anxiety is ways that don’t lead to more anxious thoughts, feelings, behaviours or physiological symptoms, preventing the vicious cycle from getting started.

Often, the first sign of anxiety is physiological. By learning to recognize what your anxiety-related physiological symptoms are, and learning to become aware of them when first start, you can deal with your anxiety before it begins to build. Mindfulness is a great way to learn to become aware of any physiological symptoms you’re experiencing as a result of anxiety.

Cognitive therapy, and cognitive behavioural therapy (CBT) are effective tools for helping you to understand how your thoughts and behaviours contribute to your anxiety, and can help you make adjustments in your thinking and behaviours that will allow you to deal with your anxiety, and reduce the amount of anxiety you’ll experience in the future.

Both mindfulness and CBT/cognitive therapy can help you learn to deal with the intense emotions you may experience when you begin to feel anxious, without making these emotions stronger or generating further anxiety.

The earlier in the process you become aware that these vicious cycles of anxiety are starting, the more options you have to deal with them. Once the cycle of anxiety begins to gain momentum, it is more difficult to break.

Mindfulness and cognitive therapy/cognitive-behavioural therapy (CBT) for anxiety can help you recognize the first signs that you’re beginning to feel anxious, and learn how to deal with your anxiety in ways that prevent it from cycling out of control.

I’m a Toronto therapist specializing in helping people overcome anxiety, depression and low self-esteem. For more information about how you can benefit from cognitive therapy/cognitive-behavioural therapy (CBT) for anxiety and mindfulness-based therapy, or to make an appointment for counselling or therapy in Toronto, please call me at 416-516-6024 or email greg@gregdorter.com.

The Vicious Cycle of Anxiety

Greg — Wed, 27 Apr 2011 16:58:37 +0000

According to the cognitive behavioural therapy (CBT) approach to anxiety, one of the reasons that overcoming anxiety can be so difficult is that anxiety generates vicious cycles involving your physiological, cognitive, behavioural, and emotional domains. We looked at these four components of anxiety in a previous post. Now we’ll look at how they act together to form vicious cycles that create and maintain anxiety.

In the cognitive behavioural therapy (CBT) model of anxiety, the vicious cycle begins with an anxiety-provoking situation. This situation can be something external such as a work commitment, a trip, a social engagement, or any other event happening in the future that you’re worried about. Anxiety can also be provoked by something internal such as a physiological sensation, a thought about something you’re dreading, or an unpleasant emotion.

This anxiety-provoking situation then triggers a vicious cycle involving the four domains, as depicted below:

For example, you’re at a social event, and feeling shy, and this triggers a physiological response such as increased heart rate, or blushing, or sweaty hands. You become aware of this physiological symptom and think, “Oh no. Everyone just saw me blush”; or “What am I going to say? I have nothing to talk about.”

This thought can lead to more physiological symptoms. Or perhaps it leads to an emotional response, and you start feeling nervous or scared. And this leads to a behaviour, such as stuttering or mumbling your words, or just not saying anything. This can lead to another thought: “I’m making a fool of myself. Why did I even bother to go out?” And this can feed into further physiological symptoms, or thoughts, or emotions, or behaviours, each of which generate increased anxiety.

Panic attacks usually begin with a physiological symptom. Perhaps you notice your heart rate increase. Then you start thinking, “Something’s wrong. I’m going to have a heart attack.” Then you start feeling scared. This increases your heart rate. And so on. Then, if you can, engage in an avoidance behaviour and flee wherever you are, or vow in the future to avoid the situation that lead to the panic at all costs.

Worrying usually begins with a “What if?” thought. “What if I screw this up?”; “What if something’s wrong?”; “What if something bad happens?” This can lead to emotions such as fear or dread. These emotions can lead to a nervous feeling in the pit of your stomach. When you notice this feeling, on top of everything else, you start to worry about the anxiety you’re experiencing. And so on.

In each of these examples, there was an anxiety-triggering situation that set off a vicious cycle of interactions in which the physiological, cognitive, behavioural and emotional realms feed into each other, creating more and more anxiety. In a future post, we’ll look at some of the ways that mindfulness, and cognitive therapy and cognitive bevhaioural therapy (CBT) for anxiety, can help you break these cycles.

I’m a Toronto therapist specializing in helping people overcome anxiety, depression and low self-esteem. For more information about how I can help you end your vicious cycles through mindfulness and cognitive therapy/cognitive-behavioural therapy (CBT) for anxiety, or to make an appointment for counselling or therapy in Toronto, please call me at 416-516-6024 or email greg@gregdorter.com.

Mindfulness From Your Computer or Smartphone

Greg — Fri, 22 Apr 2011 15:39:02 +0000

Often, the more technology we have in our lives, the more difficult it is to practice mindfulness. Our computers, laptops, cell phones, HDTVs, iPods, tablets and whatever other new gadget comes along, offer us so many different ways to stay busy and distracted all day long, allowing stress and anxiety to build as we go about our lives without being mindful.

But as people recognize how difficult it can be to stay mindful in our digital world, applications are being developed to help prevent us from getting too caught up in all the technoogy that surrounds us, and offering ways to come back to the present and be more mindful.

Digital Mindfulness Bells

In a previous post, we looked at how you can use the idea of a mindfulness bell as a cue to pause what you’re doing and take a few moments to be mindful. Technology, which is one of the things that often interferes with our attempts to live a more mindful life, now offers us some ways to incorporate mindfulness into our busy, computer-, internet- and smartphone-laiden lives.

We can now take advantage of applications for our computers, iPhones and Android phone that will play a mindfulness bell throughout the day at set times or random intervals, helping us find those moments of mindfulness during those times when we’re stuck on our computers or attached to our phones all day, and can so easily wind up stressed and mindless.

Mindfulness from your Computer

If you want more than just a bell, there are programs and apps for that, too. Stillness Buddy runs on your PC or Mac, and provides a variety of short “moments of stillness” and longer “mindfulness pauses,” spread out during the day. These breaks are very brief so they don’t interfere with your work, and you choose their duration and frequency to suit your preferences and schedule.

The exercises have been designed in such a way that they can be carried out very discreetly, so you can do them in the middle of a busy office, without anybody noticing that you are taking a very important moment to re-connect with your own stillness.

Mindfulness from your Phone

The Mindfulness App for the iPhone, allows you to select from a number of guided and silent meditations ranging from 3 to 30 minutes in length, create your own customized meditation, and set mindfulness notices that act like a mindfulness bell. Mindfulness Meditation is a similar app that offers a series of mindfulness meditations.

The Potential Project: Mindfulness app for Android, is “specifically designed to help people integrate mindfulness training into a busy and active work life.” It allows you to listen to mindfulness practices on your phone, create reminders to help you remember your mindfulness training during the day, and create practices of custom length with silence and mindfulness bells.

The Mindful Solutions at Work Program was created by Elisha Goldstein. We looked at some of his mindfulness exercises in posts onGive Yourself a Break From Stress and Stop Stress and Anxiety. This new mindfulness app for the iPhone or iPad introduces simple mindfulness practices to integrate into your day, keeps track of your practices, and sends email reminders of how you’re doing to help you stay on the path. Here’s a two-minute video that shows you how this app works in daily life.

If you find yourself stuck on a computer all day or glued to your phone, instead of letting this become a source of stress and anxiety, finds ways to take advantage of that technology to help you practice mindfulness. Instead of playing minesweeper or solitaire the next time you’re at your computer and need a break, try a few minutes with one of these mindfulness programs. Next time you pull out your phone to start playing angry birds, try running a mindfulness app instead.

It’s so easy to get caught up in the stress that is all around us. When we have some free moments, instead of mindlessly distracting ourselves, we can use these moments to return to the present, give ourselves a few moments of mindfulness, and then return to our days more centred, more relaxed, and more present.

Traditionally, mindfulness has always been no further away than your breath. No matter where you are or what you’re doing, your breath is always right there with you, and can function as an anchor to bring you back into the present and into mindfulness. These days, mindfulness is also no further than your nearest computer or smartphone.

I’m a Toronto therapist and counsellor drawing from mindfulness-based approaches to therapy to help people overcome issues such as depression, anxiety, stress and low self-esteem.

How to Deal With Your Emotions

Greg — Wed, 04 Aug 2010 18:55:12 +0000

In some earlier posts on emotions we learned that ways in which we often try to deal with emotions—such as trying to problem solve, control, or avoid them—tend to be counterproductive. We also looked at a number of more helpful ways we can deal with our emotions such as validation and acceptance.

In his book, The Worry Cure, Robert Leahy provides a flow chart that summarizes the various ways we can deal with our emotions and the results are tend to follow. The chart highlights undesired results that tend to arise when we try to avoid our emotions in various ways, or when we invalidate our emotions by telling ourselves that they are wrong.

Leahy notes that dealing with our unpleasant emotions by trying to avoid or suppress them “reflects the belief that you cannot handle emotions, that emotions will overwhelm you, and that your emotions do not make sense.” This leads to negative consequences such as worrying and ruminating and more unpleasant emotions.

People who engage in these ways of dealing with their emotions tend to “feel they have less control over their emotions in a display less acceptance of their feelings, and they blame other people for their feelings.” When emotions feel like they are beyond your control, they become more difficult to tolerate and seem more overwhelming.

The chart also shows that when we don’t fight our emotions, and are able to see our emotions as normal, we can then engage in more positive ways of interacting with our emotions such as accepting, expressing, validating and learning from them, all of which are ways of bringing mindfulness to our emotional experience. These positive ways of handling difficult emotions makes these emotions manageable, and allows us to experience them without becoming distressed and overwhelmed.

Everybody experiences unpleasant emotions. It’s a natural part of our existence. The good news is that there are ways we can interact with these emotions that make them manageable, and allow us to experience them as a normal part of living, rather than as overwhelming burden from which we need to escape.

I’m a Toronto therapist specializing in helping people overcome depression, anxiety, and low self-esteem.

For more information about how I can help you learn to deal with your emotions, or to make an appointment for counselling or therapy in Toronto, please call me at 416-516-6024 or email greg@gregdorter.com.