Before you go on to read this, I should tell you that mental health issues are complex and what I’m suggesting is too simple for some concerns. Another aspect I would like to stress is that it is always best to work with a mental health professional as it kind of gives an outsider perspective, and expertise, among other things.
Now, if you are someone who cannot afford a therapist or who is contemplating what happens in it, you can try what I’m suggesting next.
Step 1: Describe your problem. This could be in a written format or as a tape/audio or a drawing. Look for these things: What are the most obvious effects of the problem on your life? How long has it happened? What are some of the things that led to it or added to it? Are there people who are responsible for this? Who gets affected by this apart from you?
Step 2: Give your problem a name. Anything that suits it best. A client of mine would call their anxiety “the big giant head” – a reference to a controlling character from the series, 3rd rock from the sun as their anxiety would consume them as if it were the voice of God. Now, ask yourself, what influence do I have on the problem? – Now, this question is weird for a lot of people. It sounds absurd. Can I ever have any influence on my anxiety or depression or mood disorder? Turns out you do. This is how a client of mine put. “I influence my anger such that I don’t let it make me hit people. No matter how angry I get, I stop it at yelling max”. So this is the influence that the person has on their anger.
Step 3: Find out times when, despite the problem being there, you have not behaved in the way the problem would like you to. For example, if you gave a speech despite your anxiety killing you, that was an alternate behavior. That was an exception. Ask yourself, what made me do that? What was I thinking? What was I feeling? Quite often, exceptions are the key too change but we are so caught up with the problem, that we forget to pay attention to the exceptions.
Step 4: Find out the kind of thoughts you have about yourself and the problem. This can be done with an exercise called the downward arrow. Here’s an example. Neeta feels that “I must comply with others wishes if I want them to like me” – Then she asks herself and that means? – That others must like me – And that means? – If they don’t like me, I’m worthless – And that means? – i’m worthless. So, to make sure that “I’m worthless” does not surface, neeta compensates with pleasing behaviour. Now, some sort of pleasing behaviour is socially required, we are only talking of extreme ones which come at the price of our self-esteem. So, this is a good way of the kind of thoughts you’re having about yourself and the problem. Some thoughts are not helpful, they are called cognitive distortions. They make you see the world through a coloured glass. Here’s a list of common cognitive distortions. And here’s how you fight them.
Step 5: Once we identify our thought patterns, it may feel like “I’m such a loser to think like that” or “will I have to always fight my thoughts?”
Here’s the good news, along with naming the problem (which helps you to see the problem outside of you, something which is not your personal fault), finding your influence on it (gives you a sense of control), finding out exceptions (what you’re already doing right and which can be done more often), finding out cognitive distortions and fighting them (helps to change your thought process), there’s one more thing we can do : not think of “my thoughts = me”. Just like wearing a blue shirt does not make you blue, some of your thoughts don’t make you who you are. When we start thinking of thoughts as facts that need to be believed or commands that need to be followed, we do things that we do not like. For example the thought “I must go check that lock” – even when we have checked that lock many times before, becomes a compulsion and reinforces the OCD. Therefore, we have taken our thoughts as facts/instructions that are right and need to be acted upon. This is called “Cognitive Fusion” which literally means, fusing with your thoughts.
So, now that we know that our thoughts are not true, not real instructions and not helpful, how do we get unstuck? We do so by recognizing them but letting them come and go. There are many ways of doing this. You could do mindfulness meditation. Or you could do thought-distancing. An example of thought distancing:
“I’m an idiot”
“I’m thinking that I’m an idiot”
“My mind is telling me that I’m an idiot and I’m noticing that”
This helps to ensure that you distance from your thoughts in a way that you’re looking at it as an outsider as a process of the mind rather than something to believe in. Another way of accepting your thoughts and let it come and go is to visualize your thoughts floating away like clouds, or like leaves on a stream.
If you’re too caught up with your thoughts, asking yourself “will thinking this help me?” is a great way of pulling out. However, for you to do this, you need to outline your values. So if your value is to be a person who is helpful, you can ask yourself “Is the thought ‘people are evil and not worth helping’ going to help me achieve my value of being helpful?”
Bringing your values into perspective and pointing out that the current thought pattern is not helping to do so, is powerful to put things in perspective.
So, what I have tried to show you is – clarity of the problem, looking at it from the outside so as to step away from it and know that you DO have some control, noticing exceptions and making them the norm, knowing the role of your thoughts and beating the unhelpful ones and accepting your thoughts without believing in them. All of this draws from three therapies: narrative therapy, cognitive behaviour therapy and acceptance and commitment therapy. You are welcome to look these up for further help. Some recommended books are Feeling Good by David Burns, Get Out of Your Mind and Into Your Life by Steven Hayes and Step Out of Your Story by Kim Schneiderman.
If you are looking to start therapy in India: Here’s a crowdsourced list of therapists. If you would like phone help, try calling Icall, a helpline run by TISS. For online therapy, you could try out https://www.typeathought.com.
If you have any questions or suggestions, do let me know in the comments. I will try to get back as soon as possible.