“We are
what we repeatedly do. Excellence, then, is not an act, but a habit.” -
Aristotle
When
working with clients, I often encounter the assumption that therapy takes place
mostly inside the office. That is, the most effective aspect of therapy lies in
the discourse between the therapist and client. Though forming a strong
relationship between practitioner and client is an important part of change,
much of the vital work takes place between sessions. In Cognitive-Behavioral
Therapy (CBT), this interim work is called homework, and is assigned by
therapists to put into practice the techniques and goals established in
session.
For a
long time, I was opposed to homework and was under the same assumption as many
of my clients. However, as I become more seasoned, I realize that I have
unofficially been using homework in my own life to change how I felt and behave.
For example, tracking how many hours I sleep, calories I consume and setting
goals each week to improve my sleep schedule and diet.
The key
to homework in a therapeutic setting is that it brings awareness to our habits
and allows us to note the relationship between our habits, the environments we
occupy and how we react to them. Practitioners such as Albert Ellis (REBT),
Aaron Beck (CBT), Christopher Martell (BA), and Steven Hayes (ACT) have
developed behavioral interventions built around the notion that the habits we
choose have a tremendous impact on how we feel and think about our lives.
Below
are 4 Ways Our Habits Shape Our Mood:
1. You are what you think. One of the touchstones of CBT is the
notion that our thoughts and speech become habitual as well, and that the
way we think has an effect on how we feel and behave. For example, using
the word “should” can cause us to feel guilty about certain obligations in
our life as well as our self image. I should be slim and fit, I should
call my parents more often, and I should enjoy my
job/house/hobby/life more often. A simple word like “should” externalizes
the demands on our lives and can cause us to feel out of control. However,
replacing “should” with “I would like to” places the demand and
expectation back under our control. Notice how “I would like to call my
parents more often” evokes a less guilt-ridden response than “I should
call my parents”.
Being mindful of the way we
talk and think can have a tremendous impact on how we feel about situations,
people, and activities. Check out a list of more cognitive distortions here.
2. What we do affects how we feel. As with our thoughts, the way
we spend our time has an effect on the way we feel. For example, spending time
in rush hour traffic causes us to feel different than watching our favorite
show or having coffee with a friend. This seems like common sense, no? However,
what we often overlook is the role scheduling plays in our lives and happiness.
The more we engage in enjoyable activities, the more likely we are to continue
doing so and the more we do so, the better we feel.
The cornerstone of Behavioral
Activation therapy is the scheduling of activities that are enjoyable or make
us feel accomplished. Actively scheduling in more enjoyable activities or
rewarding ourselves for accomplishing difficult tasks can help keep us
motivated and improve our overall health.
3. Escape can be a trap. One impediment to habit change is avoidant and
escape behavior. Avoidant behavior is just as it sounds, avoiding situations
that we find aversive or uncomfortable. For example, those who feel anxious in
large crowds avoid parties, concerts, grocery stores, etc. in order to escape
the feeling discomfort caused by such situations. It is more enjoyable to be
away from these situations, so the behavior is reinforced (perpetuated) by maintaining
the escape behavior.
Since avoidance can be more
comfortable than encountering the aversive situation, it becomes habituated.
This can cause problems, such as isolation, loss of contact with friends and
avoiding situations that are otherwise enjoyable. Gradually re-engaging in
pleasurable activities and reducing avoidance can help improve mood by
increasing the opportunities to feel accomplishment and enjoyment (Cuijpers
et al., 2007).
4. Small steps make a big difference. Starting a new habit can be
difficult and changing an old one can seem impossible. This is normal. However,
if we recognize the habits that cause us to feel anxious, depressed or just
uncomfortable, then we have won half the battle.
Awareness is the first step in
changing our habits, both mental and behavioral. After noting the situations,
thoughts, or feelings that prove problematic, we can slowly develop ways to
combat them. It helps to start small and build gradually towards the goal. For
example, if you want to begin a walking routine, start by simply purchasing or
wearing the proper exercise clothes for the first week. Next, walk for 5-10
minutes around the house or in the neighborhood. After that becomes routine,
add 10 more minutes and so on until you’ve met your goal (ex, 1 hour, 3x a
week). If the next step becomes too much, cut the goal back and begin to build
it up again.
Through gradual exposure,
situations, objects, and emotions become more tolerable and less aversive. After
some time and a consistent schedule, they may even become pleasurable! For more
detail on gradual exposure and how to design such a program, click here.
Practice
Makes Perfect
Like
with most skills in life, our physical and mental behavior takes time and
practice to shape. Being aware of how we think, feel and behave provides us
with a great advantage by allowing us to understand the role we play and how we
react to life’s events. While this is a simplified version of the techniques
mentioned, even the smallest positive change in our routine and thinking can
gradually build into a new habit.
Photo by Mrhayata