4 Simple Mental Health Lessons from a Cognitive Behavioural Therapist
The world is opening its doors again and—should all go well—by 19th July regular programming will resume. It’s a bittersweet time. After wishing for normality for so long, many of us are feeling more than a mere tinge of trepidation. We can’t (and shouldn’t) ignore the mental impact this lifestyle shift is likely to have on us.
There have already been significant red flags. Back in March 2021, the charity Rethink Mental Illness reported a 175% surge in people looking for mental health guidance online compared to the previous 12 months. As Aaron Pinkney, a Cognitive Behavioural Therapist, explains, it’s no surprise that more people than ever are struggling.
“I'm more stressed and I've got some good resources,” says Pinkney. “So, someone who hasn't been for training, I can presume may struggle. I've seen referrals coming in for people that normally wouldn't have come into the service—people that for the first time have identified that they've got difficulties because we've been left with their own thoughts and feelings in the house. My hope is that people don't feel ashamed.”
“If we go back out and get a normal routine, we're very busy and it can be overwhelming,” continues Pinkney. “It’s like an adjustment difficulty. So if anyone feels like they're not that usual self, that's okay. The truth is that after this period, most people will bounce back without any input. However, some may need extra support.”
WHAT IS COGNITIVE BEHAVIOURAL THERAPY (CBT)?
Cognitive Behavioural Therapy (CBT) is one avenue that offers the guidance you may need. “There are two components to CBT. There's the cognitive stuff; the way we think, and the behavioural; what you do,” explains Pinkney. “It's got an evidence base—there's research confirming it works. We live in a very risk-averse world and so we want outcomes. It's very suitable for companies and the NHS to use.”
“I think it's popular because it's time-limited and that fits with people's lifestyles,” says Pinkney. “CBT is condition-specific. If you've got anxiety as your main difficulty, that will be the focus of the sessions. If depression is your main problem, that'll be the focus from session one till the end.”
While not everyone needs to engage with CBT in a formal manner (i.e. through a doctor’s referral), the practice offers useful techniques that most of us can apply in our everyday lives. So, to get a flavour of this approach and how it could help you, Pinkney offers four simple CBT-based lessons.
Lesson #1: Emotions are normal — be curious about them
“CBT doesn't disregard emotions but it doesn't get fixated on them,” explains Pinkney. “As humans, we have evolved to use emotions. The anxiety kicks in and you think ‘Oh, something's not right here.’ But with CBT, it gives us a chance to just stand back and go ‘hold on, I acknowledge his emotions there. But what else is going on?’ Emotions are natural and helpful. Sometimes we overly fixate on them.”
If you find yourself focussing on negative emotions, Pinkney suggests a smooth change of perspective. By becoming curious about your feelings and what is causing them, you may find them easier to manage.
“So it's a philosophy of being curious,” he says. “It's about being non-judgmental and seeing things the way they are. Not distorted too high. Or too far too black. Not too white. There's a middle ground and that’s a beautiful place to be in. You can't necessarily control the environment, but you can control how you respond.”
Lesson #2: Anxiety can be your friend
Most of us see anxiety as our enemy. It’s something we fear and, oftentimes, it can impede our day-to-day life. However, as Pinkney explains, this emotion evolved to protect us, rather than cause us any distress.
“Anxiety is something we all have. For some people, their anxiety is too high for their personal liking. Many people with anxiety disorders avoid that emotion,” says Pinkney. “Anxiety is adaptive and it helps you survive. It's done a great job right for thousands of years to keep us safe. So, it’s about changing the relationship with anxiety. Rather than fearing it, it's about approaching it in a way that it's actually your friend.”
Of course, when you’re dealing with anxiety in seemingly normal situations, there is a CBT technique that can help. “A key approach here is called ‘habitation’”, says Pinkney. “That means we gradually expose ourselves to the things we find anxiety-inducing. You can think of the exposure targets on a ladder. You might actually not always go up the ladder. You might take a step back and that’s okay. You tried and you can try again.”
Lesson #3: Feeling unproductive? Start small and keep track
Lockdown has been a productivity roller coaster. Switching your daily commute to a home-working setup was an adjustment in itself. However, with restrictions being lifted, many of us are facing yet another upheaval. If you’re finding it hard to self-motivate, you’re likely not alone. Luckily, the answer could be to start small.
“When it comes to motivation—which is a huge component of depression—we always go back to basics with this. So, for productivity, my advice is to start with something that's ridiculously small,” says Pinkney. “It's got to be realistic. Start small and then acknowledge what you have done, not what you haven’t. It’s about collecting evidence that challenges your perception of yourself.”
Stuck focussing on the pile of tasks you haven’t got done? Pinkney suggests keeping track of what you’ve done each day in a clear and concise way. You don’t have to write an entire memoir. Instead, keep things simple, grab a pen and notebook and then list the following:
- What day of the week is it?
- What have you done?
- How did that make you feel?
- What were some thoughts?
Alternatively, if you prefer to digitally track your productivity, there’s a treasure trove of handy smartphone apps out there. Check out Day One, Grid Diary, and the Five Minute Diary, to name just a few.
Lesson #4: Counter self-criticism with self-care
What story are you telling yourself about yourself? The way that you perceive yourself and your value is likely to have a direct impact on your emotional well-being. If you’re continuously putting yourself down, for example, you may have a wholly negative view of your worth. One helpful tool is to notice the thought as it happens.
“Catch yourself when you’re having that critical moment. Because you may not always become aware of it, as it's not your conscious mind,” says Pinkney. “When there's a feeling there’s a thought, and when there's a thought there's a feeling. There's a cycle there and awareness that can often take some of that sting out of it.”
With any luck, simply acknowledging the self-criticism will make it easier to combat. However, when that doesn’t do the trick, Pinkney suggests using self-care to rewrite your inner narrative.
“You could repeat self compassionate phrases,” he says. “It doesn't have to be something that you don't believe, such as ‘You deserve the best in the world’. A lot of people might say that's too far-fetched. Instead, try something that you believe has some truth to it. So, the best one I've seen is probably ‘You are good enough’.”
As we slowly return to normal life, CBT can help people with a variety of difficulties and there are plenty of ways to access it. “You might be someone who struggles to engage with anyone, so you can do it by yourself—self-help,” says Pinkney. “You can do it with a therapist. You can do it in a group. You can do it lecture-style with 100 people plus. You can do it online. For me, it's about finding what your learning style is.”
While this is a troubling period for the best of us, Pinkney has a couple of final thoughts. “If there are two things I want people to take away, it’s these: 1) Be kind to yourself, and 2) You are not alone—there is help out there.”