Hi sweet @
Rounded Apathy
The subject you write about raises some fundamental questions and I will try to answer them. It would take me hours to talk about all this so I will try to be exhaustive and not forget anything but I know that if you have any doubts, some of your questions will remain unanswered and I am sorry in advance
To begin with, let us define thoughts:
Concepts and Notions
In the context of mood or personality disorders, or simply human reasoning, we can distinguish 3 types of thoughts
A) Types of Thoughts
-Intrusive thoughts (IT)
-Automatic thoughts (AT)
-Obsessive thoughts (OT)
1) IT: everyone has them, they are common, they are daily and permanent. They deal with all possible subjects (e.g. "
Well, it's a nice day", "
Damn, my jacket is stained", "
I think my shoes are not so nice", "
The weather is really bad today")
2) AT: it's the added value (
negative or
positive but very often
negative) to an intrusive thought
(IT), they are born from the thought patterns (I'll talk about it below) and they are repetitive and always turn around a central theme. For example, if I take one of the sentences above "
Damn, my jacket is stained, I'm really a wreck who doesn't take care of him".
So here: "
Damn, my jacket is stained" =
IT
"
I'm really a wreck who doesn't take care of himself" =
AT
Another example: "
I think my shoes don't look that good, I'm such a shit for not noticing that before"
So here: "
I don't think my shoes are that nice" =
IT
"
I'm such a shit for not noticing that before" =
AT
The value added by
AT is absolutely useless when it is
negative and it generates emotions that keep us in a harmful cycle
3) OT: These are initially
intrusive thoughts but have a particular
intensity,
frequency and
tension on the person. These thoughts are more likely to be found in addictions, in states of madness, in panic attacks, etc...
For example, "
What's happening to me?" Which will run through the person's head several times
B) Patterns
Patterns are rules of life, stored in memory, acquired through life experiences, which ensure a lasting perception of events
Patterns are the equivalent of
wearing glasses with a coloured filter. This filter, depending on its colour (metaphor for emotional tint) will generate beliefs about reality and consequently automatic thoughts (which will always revolve around the theme of your filter/schema). And as a result, these
ATs will always be added to the
IT in the same way
For example, if your pattern is
guilt, the
ATs generated will always be of the order of thoughts like "
it's my fault", "
if I hadn't done that we wouldn't be here", "
I only make mistakes", "
maybe I shouldn't have", "
I'm causing unhappiness to people"...
C) Bias
Five thinking biases have been identified as the main and most recurrent ones. These thinking biases are
ATs, but the biases do not concern the theme of the scheme, but the
error imputed to the reasoning when an event is interpreted
1) Overgeneralization: Taking an isolated fact as an absolute reality
--> "
I missed my appointment, I have always been an irresponsible person".
2) Selective abstraction: omitting the whole event and focusing on a detail without its context
--> "
She looked at me wrong when I talked to her, she doesn't like me".
Yet the woman you are talking to has just hung up on you with someone who insulted her on the phone. So her anger is not directed at you
3) Minimise/Maximise: exaggerating or minimising the real impact of something
--> "
I got my degree, yes maybe, but that was lucky" (Minimise)
--> "
I forgot to send an email at work, I'm going to get fired" (Maximise)
4) Personification: essentializing oneself as responsible for what one suffers
--> "
They had a fight, it's because I was hanging around, it's my fault".
5) Arbitrary inference: drawing conclusions without evidence
--> "
They laughed, they are laughing at me".
When, since you didn't hear what they were saying, they might have been telling jokes to each other
D) Conclusion
So to recap, this is how humans work:
Life experience -->
Schema (one or more with one or more themes) -->
Beliefs about the world -->
Systematic generation of AT related to the schema, and bias
As you will have understood, we need to shake up this schema, make it more flexible, work on it so that it no longer functions alone and in a predominant way
E) Example of a Spiral
Finally, here is what the spiral called "
cognitive-behavioural" looks like, I give an example with the fact of missing something:
Missing a job interview ->
AT ->
Negative emotion ->
AT reinforcement ->
Lowered self-esteem, Isolation, Reduced motivation and actions ->
Anxiety ->
Missing another job interview ->
AT ...
And so on, leading to depression, suicide, loneliness...
How do we counter this?
I'll be honest, even if medical support gives the best results, the road is long, the risk of relapse is permanent and by the way, relapse does not mean failure but progress. Because relapse allows the body to test the maintenance of a change, but the problem is that relapse is demoralizing. In short, it's long, hard, difficult but doable with willpower and above all with tolerance towards oneself. You have to be able to be proud of everything, even the smallest things you do when you embark on such trials.
I preferred to be realistic because magic does not exist, but change does.
The work is in fact multifaceted and if you are supervised by professionals specialised in cognitive behavioural therapies, you will be in the most optimal environment
A) Cognitive Work
1) Keep an eye on the AT (on a sheet of paper, in a notebook), as often as possible, every day, over several weeks, months. You have to write them down somewhere and keep all these notes.
2) Understand their common theme by grouping them together and looking at them globally, by sorting them...(Rejection, Loneliness, Guilt, Perfectionism, Anger, Injustice, Incompetence, Imposture...)
3) Submit to each AT a Socratic questioning (to ATs written in the notebook or suddenly popping into your head)
*Socratic questioning : Mode of thought where for the individual, nothing is taken for granted, everything is subject to questioning and to caution when interpreting things
For example, if your
AT is "
I didn't lock the door, I'm a shit".
Ask yourself "
Am I really a shit?", "
What makes me say that?", "
Are there really facts that prove I am a shit? Which ones and why?" "
Do other people really think I am a shit or is this just my own opinion?"
This questioning
shakes up beliefs,
ATs and schemas. It needs to be
repeated regularly for it to become an almost new way of functioning for you. Obviously, if you see that with time your thoughts no longer hurt you, there is no need to stress or feel guilty for not acting socratically. Even if doubting is a wisdom in my eyes, this technique just helps to break the impact of
ATs
4) Once the doubt is installed on the ATs, submit them to possible alternatives and always consider them as an explanation of an event
E.g. : "
I didn't lock the door, I'm a shit"
(AT)
--> "
Am I really a shit because I didn't lock up? Can I really be defined as that by this simple event?"
--> "
I know I didn't sleep well last night, I'm aware of being absent-minded and stressed about my appointment, I think I would have been more alert if I wasn't going through all this" (Emission of alternatives to consider)
5) Identify and relax Schemas
This echoes the work where you identify the themes of the thoughts, the subject, the theme common to all these thoughts, is the schema. You have to identify it, question it, understand it and counter it with all the things I have listed before so as not to let it dictate your perception of things
6) (If possible) Apply or test the thoughts in daily situations to maintain the change, reinforce it
To take the example of forgetting to close the door, one day, or it's a weekend and there's nothing planned, you can go out and at the moment you go out, close the door and say to yourself "
Today I didn't forget, that proves to me that I'm not a shit but sometimes, preoccupied with several things like everyone else".
B) Behavioural work
The
cognitive-behavioural work is twofold, to remedy the thoughts is good, but the behaviour does not follow (if for example I fail in wanting to do something), it will generate emotions which will once again generate thoughts and the spiral is started again.
Behaviour generate
Thoughts and Emotion and
Thoughts and Emotion modulate
Behaviour.
So the behavioural work will really depend on the disorder the person has (because from one disorder to another the patterns are not the same and neither is the behaviour)
From what I've read about you, I have several hypotheses but I don't have enough information to orient myself towards one more than the other
I hesitate between
- Panic disorder (recurrent anxiety attacks leading to hyperventilation, accompanied by strong anxieties, fear of losing control and sensations of imminent disaster)
- Post Traumatic Stress Disorder (Reliving scenes of death, through flashes, dreams, shocking, powerful and haunting images. An inordinate fear of dying or being threatened, a feeling of dehumanisation of the event, avoidance but also feelings of not being oneself or in reality)
-Generalized Anxiety Disorder (characterized by the emission of recurrent, frequent and irrational anxious thoughts about either current (e.g., if you have an exam tomorrow) or possible future (fear of not having enough money when at the moment it is fine). The anxiety is constant and can be reinforced over time. The biggest problem for these people is considered to be that they cannot tolerate uncertainty, not knowing. They think that worrying usually allows them to prepare for the worst, to find solutions and also to protect themselves and or their loved ones)
I'm not going to go into too much detail in this section because it needs to be framed and I don't want to lead you astray when no one can see how you're doing things.
But to make it simple, among the classic methods, professionals often use:
1) Exposure: this means confronting (in real life, with a virtual reality headset, by imagining...) what we fear so that the body reacts less and less emotionally to what affects us. This exposure must
last long enough to reduce anxiety,
must be repeated so as not to have a traumatic effect,
must be done in steps of traumatic intensity and the person
must not avoid what he or she is exposed to.
If, for example, you are tired of worrying about things that may or may not be happening (in the context of Generalized Anxiety Disorder, I mean) you can either, depending the type of thoughts you have:
Current: Expose yourself to the situation, during several times (if the situation = job interview) and over several days
For example, here is the way somebody could fight his fear with exposure
-->
Monday: for 15 minutes you only imagine the place where you'll have your appointment and you stop once anxiety totaly vanished
-->
Tuesday: for 15 minutes you imagine getting out of your house, walking to your appointment (then stop when the anxiety subsides)
-->
Wednesday: for 15 minutes you imagine yourself getting out of your house, walking to the address and entering the business to say you are coming for an appointment
-->
Thursday: same thing, for 15 minutes, leave your house until you get to the reception desk, but this time you also imagine yourself meeting the person you're gonna spend time with for the interview and sitting across from them in the room
-->
Friday: same for 15 minutes except this time you dare to imagine the part where you start the interview and do it
Staggering is interesting, you have to do this and always
make sure you go all the way and don't give in to anxiety.
Never stop exposure till the anxiety is not overcamed, vanished. You have to overcome it but you also have to be tolerant with yourself and not imagine the worst directly, especially if you don't feel capable of it.
Possible: In rare cases such as this, it is better to take a worrying thought (e.g. "
I am afraid I will not have enough money to live on") and expose yourself to the scenario, as if you had no money left, imagining the worst, the catastrophe right away.
Obviously, you have to let the anxiety get to you, resist it and finally, when you are calm, move on because that's when you win. What you have to do during this disaster exposure is to use
Socratic questioning and to ask yourself about all the disaster scenarios that exist in relation to your initial thought.
Example of
Money and disaster scenarios
"
Bailiffs come to seize property"
"
Homelessness"
"
Debts"
Then ask yourself "
OK, maybe I could end up on the street, but how would I bounce back?", "
This seems far too catastrophic for my situation, can this really happen?", "
Am I really destined to become one?", "
What could I do to prevent this from happening to me?"
And so on for each theme
C) Others Behavioural Work
Then there are other approaches like but I won't detail them
1) Relaxation
2) Situational awareness (pretend that the thing you want to work on is happening right in front of you, and so you have to learn to react to it, to work on it
This can be very good
-Assertiveness training
-Training in solving actual problems
-Role play
-Emotional identification workshops...
3) Thymic self-evaluation
Note 3 times a day your mood (morning, noon and evening) from
0 (emptiness, absolute suffering) to
10 (absolute happiness). It helps to realise that moods fluctuate and that the brain only focuses on the bad times and forgets the good times.
4) Self-assessment of pleasure
For each activity performed, give a score from
0 (no pleasure) to
10 (absolute pleasure). It helps to realise that we still have passions and that the brain sometimes makes us believe that there is nothing left.
All of this depends on the topics that the person wants to discuss with the accompanying carer
Even the smallest things are good for healing
To finish with all this, my message was very long to write, sorry for not having done it earlier, I really hope it will help !
if I'm not replying today, I'm sorry, I'm a little tired
The work is long, but since you seem motivated, you'll be able to do it without worrying
Good luck
Love