Monday, September 11, 2017

Turning Negatives Into Positives Through Cognitive Modification

As I listened to a recent lecture the professor mentioned “but, of course, not every moment of that is going to be enjoyable.” I was immediately struck by that caveat, especially the emphasis that the presumed displeasure seemed to be a natural consequence. He was referring to infant rearing. The conflict that I felt with that life script or schema for child rearing underpins the essence of cognitive behaviour therapy [CBT] – reality is only what the brain perceives it to be.

At another time I will write about how every moment of rearing my son was pleasurable. In today's posting I am instead going to articulate the primary foundation that I provide to clients receiving CBT. While much of what I provide here is still discussed during individual therapy, understanding the cognitive process is substantial and better achieved with advanced knowledge of general principles.

Whether the symptom is child custody or relationship conflict, financial disorder, employment dissatisfaction, mood disorder, body shape problems, or other wellness issues the basis lies in cognition. It is the manner in which we perceive the world that affects our actions and it is those deliberate, yet often reflexive or habitual, acts which account for these outcomes.

Our perceptions are based upon the emotional attachment given to memories. This is a point of particular importance. Emotional attachment is a significant driving force.

The societal scripts that are inculcated by our brains have the greatest staying power when attached to an emotion. The purveyors of these scripts do so to maintain order, regulate group dynamics, and best serve their interest or that of those advocating them.

So let's jump right into this with statutory law and prison. We are told that laws exist to maintain order, preserve the peace, facilitate cooperation, and provide for the common welfare of the community. While we are encouraged to abide the laws our motivation to do so is based upon fear. The fear of prison, stigma, loss of employment, loss of physical freedom, and loss of connections to loved ones is perpetuated through culture.

This lever of compliance breaks down when the perceived reward exceeds the perceived consequence. Or . . . when the perceived consequence is diminished.

Fix in your mind your impression of prison life. Do you imagine fighting, cramped miserable conditions, incessant noise, horrible food, abusive guards, and a general threat to your health and safety? What about your family connections?

Now I want for you to jump to the opposite end of the spectrum. Imagine that you are living in a gated community with a diverse population. There are sporting facilities, cafeteria, health clinic, library, and other amenities all within a brief walk. Unemployment is zero, the grounds crew keeps the community clean, and maintenance crews quickly tend to any issues in your home. Residents of this community extend their life expectancy while living there as compared to those outside the community. In the evening you may sit by the ball court, sipping on tea or lemonade while watching others stroll the pathways or workout while the sun sets. The neighborhood health clinic doesn't require appointments, often provides same-day service and dispenses its own meds. The kicker of it all is there is no charge – housing, food, healthcare, recreation, entertainment, and even clothing. It's free.

Thus, whether prison is good or bad is dependent upon perception. If it is viewed from the perspective of deprivation – what one has to give up – then it may be perceived as adverse. However, if one changes cognition to see what is obtained then the perception becomes that the experience is positive.

Here is how this plays out. The deprivation view is that incarceration is a loss of freedom. Additionally, a common view from some people is that prison is a dangerous environment where safety is lost. I see these people as a paradox. They may lock themselves in cars, in their homes, or in office buildings. Their housing community, apartment building, or workplace may have guards posted or patrolling. It seems as though they perceive their environment as being unsafe and under constant threat. The beneficial view is that prison is a respite from the responsibilities of living in that larger, dangerous society which is prohibited from bringing its problems into the inmate community. Prison, after all, is the ultimate gated-community with around-the-clock armed guards patrolling the perimeter and guards posted at the entrances or roaming throughout the housing units prepared to respond at a moments notice to any threat against a resident.

Those on the outside may see that one in prison is deprived of preparing whatever he wants to eat. On the inside I was given the privilege of being able to go to the diner with friends three times a day and have our meals served to us at no charge.

How horrible it must be to be in prison deprived of the opportunity of trying to select and pay for a healthcare plan, schedule an appointment with an in-network provider, obtain a necessary referral, get time off work for treatment, then go pick up a prescription. In prison I was stuck with walking to the hospital, being seen that day, receiving evaluation or treatment, taking hold of any prescription, and then heading off to work. Entirely without payment, employment consequence, or limitation. It was my Constitutional right.

As you may not plan to engage in an intrusion into the domain of a financial superior, such as manufacturing, transporting, or delivering drugs outside of the pharmaceutical protocol, then prison may not be on your horizon. For you I will provide some other example to illustrate this premise – that you only experience what you perceive.

You don't give up doughnuts, french fries, and hot dogs. Instead give yourself an opportunity to truly taste delicious foods, feel more elated, and savor succulent flavours more often.

You don't give up having the ability to see your child on a daily basis. Instead, you give yourself one evening a week dedicated solely to your child. You give yourself time during the week to take care of the mundane chores of living and make alternating weekends special times where your child gets your full attention.

Your spousal figure doesn't argue with you to keep you from getting your way. Rather, he or she cares enough about you to use his or her time and effort to convince you to adopt an alternate position.

Here is why I congratulate people when they get fired from their jobs. You don't get fired from a job and lose your income. Instead, you appreciate that someone made an assessment of your satisfaction with the job, determined that you would be happier elsewhere, and you took advantage of the push to change. Also, you appreciate the fortitude that you exhibited by building some savings and reducing obligations which allowed you to take a hiatus from working which builds your esteem.

These few examples are not intended to be extrapolations from a how-to list of negative thoughts changed to positive ones. If it was that simple then therapy, which is guided exploration, would be unnecessary. These examples are the outcomes.

The path to these outcomes lies in determining the emotional attachment given to the stimulus and if those are objectively valid. That is, are the feelings you have given to a merit-based job termination a universal consequence of a firing.

I used to eat doughnuts. I enjoyed eating doughnuts. The aroma alone could elevate my mood. There is a doughnut shop within view of my house. Sometimes I experience a fleeting thought that I should get a doughnut. It comes from deep within my mind based on long past experiences.

Going to the doughnut shop when I was young and getting to select my portion of the dozen meant that I was spending time with my father. It was during the weekend when he would set aside some time for this activity with my sister and I. It even continued into my adolescence on Sundays after I completed my newspaper delivery.

I don't recall much from my childhood but I know he was there for dinner most nights but that it didn't necessarily correlate to being home for the evening. We had our weekend morning but the rest of the time could be dedicated to working around the house or going back to the office. I estimate that time at the office accounted for about 60 hours in a typical week.

Thus, doughnut mornings where significant to me and I formed a strong emotional attachment to doughnuts and subsequently the feelings experienced while eating them.

While improving my wellness doughnuts clearly had to go. It took recognizing that emotional attachment to do it. I yearned for a meaningful father-son relationship. Even into my early 40's I wasn't able to actively listen to the song Cats in the Cradle without crying.

Objectively I assessed the doughnut eating experience. It was a blast of sugar tinted by flavours that nearly obscured a somewhat metallic taste which provided brief exuberance. This was followed by a depressed state that wasn't sadness but more akin to just blah. I think that is the technical term. The “Blahs” may be mentioned in the ISDM-IV. Then there was the lethargic feeling as that artificially flavoured sugary lump of dough traversed my colon having stimulated neurotransmitters and my immune system.

I also made the realization that the father-son relationship I had was what it was and eating doughnuts wasn't going to change it. My father valued his employment. He cherished the “Vice-President” title, the corner office and, I suspect, the attention of the employees with greater appreciation for that of the females.

I had an option of trying to build a meaningful father-son relationship well into my adult life or seeking solace elsewhere. I don't even like it that a so-called food was the basis of a father-son relationship. I opted for satisfaction in a strong father-son relationship. It was through a position flip though. I am the father in my exceedingly gratifying father-son relationship which doesn't include doughnuts. A Chinese buffet may be in there though. On a good day it could still include me yanking on the connective tissue in a crab claw to pinch my son's face or nearly poke out an eye as he struggles to evade the Crustacean attack.

The scripts that have molded our lens of consciousness can be modified. We are not automatons destined to follow a particular course or view the world in a particularly skewed manner. Our reality is what we perceive it to be. When properly guided we are able to see all situations objectively, without the interference of emotion, and in a manner that facilitates a positive outcome.

Whether you have seen the glass half full or half empty becomes irrelevant once you master perception and are able to see what I see – that I have a pitcher and ready access to the tap.

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