PSYCHOTHERAPY: The Mystery Solved

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Everything in your consciousness is either a sensation, a thought, or an emotion. Thoughts consist of images, words, and their relationships. Even external events are not directly accessible to your consciousness--only your sensations from those events are. Your inner observer must know that sensations are distinct from external world events.

Your inner observer must know that your sensations and perceptions can be strongly affected by your preconceptions and biases. Let your nonjudgmental inner observer use neutral, nonjudgmental language as it talks.

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Some part of you not your inner observer might be judging someone--calling them "stupid" or "bad. It will only observe the language and its effects on your other thoughts, emotions, and actions. Your inner observer may notice that condemning someone increases negative thoughts, increases anger, and increases aggressive actions.

The reaction of your neutral observer is not to condemn, it is, "That's interesting--perhaps there is a causal relationship between my judgments, my anger, and my aggressive responses. As your inner observer talks about what it is observing, it is important that it use descriptive, nonjudgmental language. If it falls into a judgmental mode, then it will lose its power to be an accurate observer. Let your nonjudgmental inner-observer avoid zingers and melodramatic descriptions. Zingers are key words that incite emotional reactions. They can disrupt thinking from a "just getting the facts" mode to an "I need to react" mode.

At times when you are observing yourself, you will undoubtedly be tempted to think thoughts like, "That was stupid, why did I do that? Innuendos, digs, subtle put-downs, and defensive comments all stir up parts of us that are anything but neutral--so avoid observational zingers of any type! Melodramatic language incites emotional reactions.

If you want an emotional reaction from someone including yourself , then you may be tempted to exaggerate or overdramatize a situation. The problem is if you exaggerate the situation, then it also gives you a message that the problem is larger than it really is.

It may also give a message that you view yourself as too weak to meet the challenge. This kind of dishonest communication is the opposite of what your inner observer is striving for. Let your inner observer "rise above" emotions and not get caught up in them. Recall a time when you got really upset and got totally lost in the emotion and experience. In that experience, you had tunnel-vision. You lost all perspective that anything else exists.

You probably felt as if the emotion was totally outside of your control. In this case your neutral observer was not engaged. In contrast to this experience--try to think of a time when your neutral observer was engaged. Haven't you ever experienced one part of yourself dispassionately observing another part as the second part gets upset?

Perhaps the experience felt a little strange, sort of like an "out of body" experience. But it is this dual processing state that you must achieve with your inner observer to accurately observe what is causing your emotional reactions.

Psychotherapy Life is not a problem to be solved, but a mystery to be lived. Thomas Merton.

To achieve this dual processing state take turns focusing on your inner observer and letting the upset part act naturally until it's finished with the episode. Right now try closing your eyes and with your "inner eye" try observing all of your bodily sensations, your emotions, and your thoughts. Try just observing them without controlling them or judging them. Especially pay attention to sequences and patterns of internal events.

As you feel emotions, notice them and label them; but during the self-exploration stage do not attempt to change them. Observe any correlation between your emotions and thoughts. Look for Sequences and Patterns. Think about times when the problem occurs. Look for sequences of events. When did the problem start? What was the order and timing of events? Look for patterns of events. What else was happening about then that might be related?

List situations when the problem occurs and situations when it does not. Think of as many situations as you can and be as specific as you can in recalling all of the events. Nonjudgmental observe each situation in depth. Listed below are some additional questions I use when gathering the "raw data" for helping clients find the causes of their problems. Use these yourself during self-exploration.

For more complex problems explore the entire history of the problem--even dating back to childhood. When did the problem begin and what conditions immediately preceded that beginning? Compare situations it does and doesn't occur in. How are the situations it occurs in similar to each other? How are these situations different from situations where it does not occur?

What if you discover that a person is normally not depressed with other people, but is often depressed alone? You might suspect that the cause of the depression has something to do with loneliness, lack of being able to "entertain" his or herself, or some other condition associated with being alone. What events regularly precede the target thoughts or actions? This will help identify what some of the immediate causes are to the actions or thoughts which we are trying to understand.

People often overlook the most obvious causes. Important antecedent causes of the problem thought or action can include the place, the time-of-day, a negative comment, a loss, or a situation you've never faced before are all examples of events that might precede a problem. Check the environment--any temptations or distractions? Often students complain because they can't concentrate on their studies.

Yet often in their study environment, the TV is playing, people are constantly interrupting them, or they have chores to do. Most students cannot concentrate in this environment because of all the distracting stimuli. In this case, finding a new study place or making agreements and being firm about people leaving them alone when they have a "Do not disturb--I'm studying" sign hanging on their door can really help. Understanding which external stimuli and events are affecting your feelings is an important step to finding possible solutions. What events regularly follow the target thoughts or actions?

The reason that consequent events are so important is that they may be reinforcing the target thoughts or actions. When children throw temper tantrums, some parents give the child what the child wants.

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It seems to work beautifully; the child stops crying immediately. Both parent and child are now happy. However, why is it that this child turns into a terrible brat who is always throwing temper tantrums? And why is it that the parents keep giving in to these tantrums?

The answer is that both parent and child are being reinforced regularly for their behaviors and reinforcement tends to increase the strength of habits. The child is being reinforced for the tantrum by the parent; the parent gives the child what the child wants. Similarly, the parent is being reinforced for giving in by the child--the child immediately stops crying and thus gives the parents what they want. How do the parents break this cycle? First they must completely stop reinforcing the tantrums. In order to speed the process they can also use some sort of punishment following the tantrums to decrease the strength of the habit.

Even though there might be a temporary increase in crying--that is a signal to the parents that the child does not like the intended punishment. Punishments are not supposed to be liked. If they are liked, then they are reinforcements--not punishments. Our emotions are like the warning lights or gauges in our cars. Our car gauges tell us what is right or wrong with important inner parts of our car such as the oil pressure, the generating system, or the engine temperature.

If the oil light comes on and we don't stop immediately, we can burn up the engine in our car. In a similar way our emotions tell us about aspects of our lives that are important to us. Some important inner value, expectation, goal, or belief may be threatened and we might not be aware of it at a conscious level. However, some inner part of us is aware of the problem and it speaks to us though our emotions. Therefore, to locate the cause of the problem, we need to follow our emotions.

Many people have difficulty identifying emotions. You may experience an emotion like anxiety as bodily sensations--tightening of your chest, pain in your stomach, rapid breathing and heart rate, and excess perspiration.

You can also observe which sensations, thoughts, or actions precede or follow an emotion. From these careful observations, you can find the emotion's causes. Don't confuse emotions with sensations, intuition, or thoughts. People often confuse other internal events with emotions. They use the word "feel" to mean many things besides emotions. For example, there is the old joke about the woman in her tenth marriage getting out of bed and saying, "What a beautiful day, I feel like a new man today!

Many people confuse thoughts, intuition, or "hunches" with emotions. Does the person mean that he feels sad because he thinks something bad is about to happen? This distinction may seem picky to some, but it can make a major difference. Anger, anxiety, and depression have different causes and different solutions. After many years of research, experts in the field still have not agreed on any one classification system.

However, it is generally agreed that anger, anxiety, and depression are basic negative emotions--and they are the most widely studied emotions. Many laymen confuse the emotions of depression or anxiety with diagnostic categories of clinical depression or clinical anxiety disorders.

The clinical syndromes are marked by extensive, prolonged, intense periods of the particular emotion. But, depression and anxiety are normal emotions that almost everyone feels at least small amounts of every day.

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Even people feeling intense emotions for awhile are not necessarily clinically anxious or depressed. See harmonious functioning chapter for more explanation. Anxiety includes subcategories of fear, guilt, stress, confusion, nervousness. Depression includes boredom, loneliness, apathy, some tiredness, sadness, and grief. There is even less agreement about a classification system for positive emotions. But I use the word happiness to refer to what I believe is the most basic positive emotion.

I think that it is inseparably intertwined with its variations of love, caring, liking, joy, peace, excitement, and ecstasy. The positive and negative emotions are related, but are like opposite ends of a spectrum. It is impossible to feel anger, anxiety, or depression and joy at the same instant. They each have their turn, depending on what our state of mind is at any one instant in time. The self-exploration process is the opposite of avoidance behavior. It causes us to look down the barrel at our most feared emotions and underlying issues so that we can solve the underlying problems--not just cover them up with temporary patches.

Pretend you are playing the old children's game in which you are blindfolded and your goal is to find a hidden object. If you get farther from the object the other kids shout, "You're getting colder. If you can stand the heat, you can control the fire. What thoughts or mental images pop into your mind as you focus on the target emotions? These pop-up associations are not just chance events.

They are often very important. The mistake most laymen make is that they do not realize that these associated thoughts are not just coincidences --they are conditioned associations and causally connected to the emotions and the problem. Therefore, following these associations can often lead to other associations that are the underlying causes of the target problem. As you think about the target situations, your emotions will vary both in type and in strength. As they vary, notice the exact image, thought, or sensation that was associated with the strongest emotions--especially the target emotion.

If depression is the target emotion and if you suddenly feel a small increase in depression, then what internal event just preceded the onset of that small increase? Answering that question may provide a valuable clue to an underlying cause. Even if a particular internal event precedes a target emotion only once, it may be important. However, when you notice that a particular type of internal event regularly precedes the target emotion, then you are really getting hot. Examples of common causes of some negative emotions follow. Anxiety is caused by uncertainty about important values and goals.

Uncertainty about being liked, about getting a job, about people's opinions, about finances, about deadlines, or about your expectations being met. Anger usually results from not accepting some loss or potential loss. The higher the stakes, the more the anger is directed at the perceived cause of the problem. A person may generate anger for power to overcome the perceived barrier. Not accepting an interruption or negative event, thinking someone wants to hurt you or is being unfair to you, or being injured and wanting to "get even.

While both anxiety and anger are states of high arousal, depression is generally a state of low arousal characterized by goalessness, loss, and lack of challenge. The person may have "given up" or be experiencing a lack of values satisfaction or reward. Loss of a loved one or job, a perceived or anticipated failure experience, not having anything interesting to do, or being alone. Depression may even come after successfully meeting goals, when suddenly goals are lacking. Test different words, images, and ideas to see if they will evoke even stronger emotions.

You can learn what causes your emotions to vary by consciously varying your thoughts and watching the corresponding changes in your emotions. Consciously focus on beautiful music or a beautiful ocean scene and observe your emotions. Then consciously focus on scenes of serious illness, famine, or death.

Compare your emotional reactions. Also, notice how rapidly they can change as you alter your focus. While clients are feeling very depressed in therapy and are focusing on how helpless they feel, I often ask them to think of a time when they were depressed and were able to get themselves out of the depression. They suddenly appear more alert, active, and energetic. They immediately begin to feel better. Then I ask them to compare how they felt when they were talking about how helpless they felt versus how they felt when they were talking about how they could cope with their depression.

They realize that when they focus on what they cannot do and focus on what is out of their control, they feel worse. But as soon as they focus on constructive problem-solving and focus on what they can control , they feel better. From this simple mental experiment, they discover one cause and one treatment of their depression.

One powerful way to dig up underlying issues is by using free association techniques. Let your inner observer just watch the chain of connections between different mental events. I explored my dream about graduate school using free association--to get to the underlying cause of my "longing" feelings. I am not normally someone who spends much time exploring dreams. However, that one had strong feelings associated with it and I felt confused. I kept free-associating and got in touch with many old memories.

I then focused on the feelings associated with these old memories. Memories of talking with other students, reading, listening to certain professors, and writing were popping into my mind. I began to see that the common theme was that I was thinking about interesting new ideas. This unique resource helps therapists build their skills in schema therapy ST by applying ST techniques to themselves and reflecting on the experience.

Paperback — Guilford Press. Harvey , Daniel Buysse. This practical manual presents an innovative modular treatment for adults and adolescents with a wide range of sleep and circadian rhythm problems, such as insomnia, daytime sleepiness, poor sleep quality, and irregular sleep-wake schedules.

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