by Steve Rose | Jul 22, 2020 | Suicide and Mental Health
On the go? Listen to the audio version of the article here:
The other day I decided to take a look at the scientific evidence on counselling. As a counsellor myself, I’ve seen it work, but I was curious about what others are saying. I searched the phrase, “does counselling work?” and was surprised by the top result. An article in the Independent stated that although counselling works in the short-term, it has no long-term benefits.
Shocked by the conclusion, I dug deeper, looking into the studies they cited, in addition to doing my own review of the literature. I discovered that the studies on the short-term benefits of couselling did not provide an accurate picture of the evidence and did not consider the various forms of counselling.
After digging deep into the scientific literature on whether or not counselling works, I came to the following conclusion:
Counselling works in the short-term and long-term, so long as it is practiced by a skilled counsellor using evidence-based techniques, in addition to having strong empathic interpersonal abilities to facilitate a supportive therapeutic relationship.
As a counsellor, I’ve personally seen many long-term transformations, but as a researcher, I know I cannot rely on anecdotal evidence. This article is a summary of my review of the literature.
The titles of each study cited below are hyperlinked if you would like to read more.
Counselling Works in the Short-term
The scientific evidence unequivocally supports the effectiveness of counselling in the short term. Several high-quality studies point to these benefits.
The following Cochrane Review concludes that counselling works in the short-term but not in the long-term:
Counselling for mental health and psychosocial problems in primary care
Counselling is associated with significantly greater clinical effectiveness in short-term mental health outcomes compared to usual care, but provides no additional advantages in the long-term.
Why might there be no evidence for long-term effectiveness?
The above review focuses on a narrow definition of counselling, distinguishing it from cognative-behavioural therapy. This is problematic since many counsellors practice cognitive-behavioural approaches and other evidence-based techniques.
The following study also finds short-term benefits but fails to demonstrate long-term benefits by relying on a similarily narrow definition of counselling:
Acupuncture and Counselling for Depression in Primary Care: A Randomised Controlled Trial
In this randomised controlled trial of acupuncture and counselling for patients presenting with depression, after having consulted their general practitioner in primary care, both interventions were associated with significantly reduced depression at 3 months when compared to usual care alone.
The following systematic review and meta-analysis reinforces the evidence on the short-term effectiveness of counselling, but again distinguishes it from evidence-based mental health interventions such as cognative-behavioural therapy:
The clinical effectiveness of counselling in primary care: a systematic
review and meta-analysis
Counselling is associated with modest improvement in short-term outcome compared with usual general practitioner care, and thus may be a useful addition to mental health services in primary care.
The following study focuses on the effectiveness of counselling for quitting smoking, finding compelling benefits after six months:
Does individually-delivered counselling help people to stop smoking?
Combining the results of the studies showed that having individual counselling could increase the chance of quitting by between 40% and 80%, compared to minimal support.
The above evidence demonstrates the effectiveness of counselling at the three to six-month mark. Let’s now consider studies on the benefits of counseling in the long-term.
Counseling Works in the Long-term
This longitudinal study followed up twenty-one months after counselling ended, finding the positive effects were maintained:
A naturalistic longitudinal evaluation of counselling in primary care
Patients who received counselling made highly significant improvements compared with those on the waiting list. These improvements were maintained throughout the long-term follow-up. This would indicate that generic counselling has positive effects that can be maintained for a long period of time after counselling has been completed.
The following study delves into the specific processes responsible for the long-term effects of counselling:
The long-term effects of counselling: The process and mechanisms that contribute to ongoing change from a user perspective
Mechanisms integral to sustained impact were: the active engagement of people during and between sessions to work toward their own solutions; and acquisition through the change process of skills which could be further built on after the counselling ended.
This means counselling works in the long-term when client autonomy is supported. This means having clients practice skills between sessions, which can be applied independently after counselling is complete.
Evidence for Various Types of Counselling
The studies supporting the short-term benefits of counselling generally defined it as a client-centered emotionally supportive role, neglecting the fact that many counsellors are qualified practitioners of various evidence-based techniques.
The following study demonstrates the long-term benefits of cognitive-behavioral approaches:
CBT as an adjunct to usual care that includes antidepressants is clinically effective and cost effective over the long-term for individuals whose depression has not responded to pharmacotherapy. In view of this robust evidence of long-term effectiveness and the fact that the intervention represented good value-for-money, clinicians should discuss referral for CBT with all those for whom antidepressants are not effective.
The above study demonstrated positive effects over forty-six months. The long-term effectiveness of this approach may be attributed to its emphasis on facilitating independent coping skills. Once practiced, clients can continue to use these skills when counselling has ended.
Internalizing effective coping skills may be the key to long-term effectiveness. This is reinforced by studies on the effectiveness of self-help methods. According to thirty-three studies in A meta-analytic study of self-help interventions for anxiety problems, using self-help methods without having engaged in counselling can also be effective long-term.
Beyond a cognative-behavioral counselling approach, several other forms of counselling also have strong evidence for their effectiveness.
According to a meta-analysis of eighty-six studies on the effectiveness of humanistic therapies, this approach shows substantial stable gains over time:
In randomized clinical trials with comparative treatment control clients, clients in humanistic therapies generally show amounts of change equivalent to clients in nonhumanistic therapies, including cognitive behavioral therapy.
Motivational Interviewing is the most recent counselling approach based on a humanistic foundation and is particularly effective for addiction. For the evidence on the effectiveness of its approach see the following list summarizing the research: Systematic and Meta-Analyses of Research on Motivational Interviewing
Lastly, the most recent form of behavioral therapies are also strongly supported by research. Acceptance and Commitment Therapy is considered a third-wave behavioral approach, focusing on process rather than the content of cognitions. For a list of the 330 randomized controlled trials conducted on this approach, click here.
Does Online Counselling Work?
Since the world has recently turned to online platforms, this question is more relevant than ever. I reviewed the evidence for online counselling in my article Does Online Counselling work? and came to the following conclusion:
According to recent evidence, online counselling is effective for treating mental health and addictions. Multiple studies show it is generally as effective as face-to-face counselling and has the benefit of expanding access to mental health and addiction treatment.
For a more detailed review of the evidence on online counselling, check out the full article here where I summarize several high-quality studies on online counselling for mental health and addiction.
Conclusion
There is a large amount of strong evidence pointing to the fact that counselling works in the short-term. Although the evidence is mixed on the long-term effectiveness of counselling, this can be primarily attributed to a narrow definition of counselling that does not include many of the evidence-based techniques cited above.
If you are interested in taking a deeper look at the research on this topic, you can find several studies summarized in this systematic review of the evidence.
Beyond the scientific evidence, I have personally seen the transformative effect of counselling in my work in various roles within the addiction field. Throughout counselling, clients find a safe outlet for expressing difficult thoughts and emotions, in addition to learning how to more effectively cope when these difficulties are present.
Counselling works by helping clients overcome mental barriers to living the life they want. A collaborative counselling relationship fosters a deep sense of trust and mutual respect, helping someone become the best version of themselves.
by Steve Rose | Jun 12, 2020 | Suicide and Mental Health
With recent protests surrounding the death of George Floyd and calls to defund the police, I have been carefully collecting my thoughts on how to contribute to the conversation.
As a course instructor in Sociology at Eastern Michigan University, I covered race relations several times in my courses on conflict and violence in society.
The discussions we had about race were always productive and in-depth, given the diversity of students in these classes, spanning the political spectrum. There were a significant number of students of color, and many students were also preparing for a career in the military or law enforcement.
Over the last few weeks, I didn’t quite have the right words for an article on the recent events. I wanted to avoid writing an article as an obligatory political-style gesture for the purpose of virtue-signaling.
I’ve been listening, following recent developments, and finally came to a point where I’m inspired to meaningfully contribute to the discussion.
Given my background instructing criminology courses on violence and conflict and my current focus on mental health, I’ve been inspired by recent calls for police reform. These calls for reform go by the popular slogan, “defund the police.”
What does it mean to defund the police?
When I first heard the slogan, I was skeptical. I initially thought they were calling for the government to stop funding the police, effectively abolishing the public policing system, turning it into a privately run service.
This sounded like a pretty outlandish idea since such a radical move would result in a significant risk to public safety and far worse social inequality.
Without a public policing system, the wealthy would buy private security, and those without means would need to turn to gangs and vigilante justice. Private prisons in the US are a prime example of how privatizing criminal matters is a bad idea. See more on that issue here.
Although the word “defund” typically means “to prevent from continuing to receive funds,” the current slogan does not generally refer to this definition. So, what does “defund the police” mean in the current context?
Defunding the police means cutting government funding to policing and reallocating these funds to preventative measures in addition to funding social workers, crisis intervention staff, and addiction counselors, to take over mental health responsibilities.
Defunding the police does not mean simply making cuts. It means reinvesting in mental health and other programs to address poverty and reduce social inequality.
The goal is to remove aspects of policing that are ineffective and reallocate the funding where it can better serve the health and safety of the community.
How defunding the police addresses systemic racism
There are many layers involved in this discussion: race relations, class relations, policing practices, and mental health. Since they are intertwined, the call to “defund the police” must be viewed from a holistic perspective.
Put simply, the history of race relations in America resulted in disproportionate poverty among People of Color. Along with this came biased policing practices and deviant subcultures within these communities to cope with poverty and distrust of authorities. These biased policing practices perpetuate generational and racialized trauma, negatively affecting mental health.
It is important to note that systemic racism does not necessarily mean any particular individual is overtly prejudice. It means the system as a whole unconsciously produces unfair outcomes for specific groups.
Throughout America’s history, police departments have generally neglected poor black communities when it comes to homicides and have taken a heavy-handed approach when it comes to petty crimes. This resulted in unnecessary violence and disproportionate wrongful police killings in these communities.
In a 2016 study on Deaths Due to Use of Lethal Force by Law Enforcement, the researchers found the victims were:
“…disproportionately Black (32%) with a fatality rate 2.8 times higher among Blacks than Whites. Most victims were reported to be armed (83%); however, Black victims were more likely to be unarmed (14.8%) than White (9.4%) or Hispanic (5.8%) victims.”
Another 2016 study titled An Empirical Analysis of Racial Differences in Police Use of Force, analyzed data from the Houston Police Department, controlling for aggravating and mitigating circumstances that might affect police interactions. The study found:
“On non-lethal uses of force, there are racial differences – sometimes quite large… even when officers report civilians have been compliant and no arrest was made, Blacks are 21.2% more likely to endure some form of force in an interaction.”
Although this particular study was unable to find a difference in rates of police-involved shootings, the disproportionate non-lethal uses of force are concerning.
It is important to remember that officer-involved shootings are not the only lethal form of force. In the case of George Floyd, no weapons were required for a fatal interaction.
This is not only an American issue. In Toronto, the data shows that in more than a third of deadly police encounters, the victims are Black (36.5%). This is particularly disproportionate since Black people only composed 8.3% of the population in Toronto between 2000 and 2017.
Also, data shows 70.3% of all victims of deadly police encounters suffered from a mental health or substance abuse problem.
The recent death of Regis Korchinski-Paquet, a Black Toronto woman, following a mental health call to police, highlights the need for police reform. The circumstances are currently under investigation, and even if racial factors are not involved in this particular case, having specially trained mental health personnel would be a more effective use of resources.
Police are the designated first-responders to mental health crises, being called to enact skills that go beyond the bulk of their training. Although training does exist, and many officers are skillful at de-escalation, the social service sector is better suited to the task thanks to their extensive education and training in this specific area.
Consider this data on police training from a report by the Police Executive Research Forum:
This data shows how in the US, recruits receive as much training on de-escalation as they do on how to use a baton, which is very little in comparison to other areas.
There has been recently growing interest in police Crisis Intervention Teams (CITs) for mental health calls. Since there is some optimistic preliminary research on CITs, perhaps integrating the roles of police, social workers, crisis intervention staff, and addiction counselors on these specialized teams may be another way to reinvest funds going forward.
How does defunding the police address systemic racism?
Defunding the police addresses systemic racism by reallocating resources to social workers, crisis intervention staff, and addiction counselors to fill the role of mental health first-responders. This would, in turn, reduce the impact of deadly police encounters that disproportionately affect Black individuals and individuals experiencing mental health crises.
Also, with fewer police-involved killings, mental health in Black communities is improved. A 2018 study in The Lancet analyzed the impact of police killings on the mental health of Black Americans, finding:
“Each additional police killing of an unarmed Black American was associated with 0-14 additional poor mental health days (95% CI 0·07-0·22; p=0·00047) among Black American respondents. The largest effects on mental health occurred in the 1-2 months after exposure…. Mental health impacts were not observed among White respondents and resulted only from police killings of unarmed Black Americans (not unarmed White Americans or armed Black Americans).”
The study concludes programs should be implemented to reduce these kinds of killings to mitigate adverse mental health in these vulnerable communities.
Beyond police killings, perceived racism is comparable to other forms of trauma. A report published by the American Psychological Association summarizes the results of a 2012 study on Perceived Racism and Mental Health Among Black American Adults, stating:
“Black Americans’ psychological responses to racism are very similar to common responses to trauma, such as somatization, which is psychological distress expressed as physical pain; interpersonal sensitivity; and anxiety, according to the study. Individuals who said they experienced more and very stressful racism were more likely to report mental distress…”
These findings are especially relevant, given recent events, in addition to the escalating racial tensions in America since the study was published.
Calls for police reform are not new, but the most recent call to defund the police goes beyond simple band-aid solutions. These more radical reforms are reimagining the role of police by addressing root causes. It may not address all of the issues, and racially biased individuals will still exist, but it is a strong start.
To use a metaphor, if your sink keeps overflowing, are you going to mop up the floor indefinitely? Or are you going to try turning off the tap?
Police are like the mops of society, cleaning up the water overflowing from the sink. Instead of putting most of our resources toward cleaning up the mess, we should start to consider better ways to turn off the tap.
When it comes to defunding the police, the purpose is not to simply use fewer mops; the goal is to use the mops more efficiently, in addition to addressing root causes. This is where education and social programs come in.
Toronto Police Chief, Mark Saunders, affirms this perspective after his recent announcement that he will be stepping down on July 31st. He states:
“I see a lot of young Black boys getting killed by young Black boys. Law enforcement deals with those symptoms and I want to help with the cure for the disease…”
We may never be able to solve every social issue, but chipping away at these root causes can result in long-term social and economic stability, reducing crime and creating safer, happier communities.
Since the shift away from community policing toward a more militarized approach, police reform has been much needed, as the consequences are becoming hard to ignore. A popular comment by Calabash4 under this YouTube video demonstrates how even police in the US Marines are not as militarized as the civilian police:
“I was an MP in the Marines and it shocks me how policing in the civilian sector, is more militaristic than it was for me as an actual military policeman. We were taught that we were protecting our brother and sister Marines and their families. We had a “police your neighbor” approach whereas civilian police are trained with an “us against them” mentality, and have been give ordinance and taught tactics used by actual occupying forces.”
This “us against them” mentality is most robust in the most impoverished areas where the criminological Broken Window Theory has been misapplied under zero-tolerance policing and stop-and-frisk policies.
Broken Window Theory suggests creating a sense of order through frequently policing minor offenses changes the culture of an area, preventing more serious crimes. The evidence suggests that this theory did not translate into effective practice. Research on this form of policing in New York City found:
“…NYPD’s aggressive law enforcement since the 1980s has added to race/ethnicity and class tensions in NYC.”
Simply defunding the police might sound like an easy fix to decades of much-needed police reform, but there are also risks.
How many resources should be reallocated? Which areas should be cut? Will public safety be affected during the transition?
The risks of defunding the police
There are significant risks involved in defunding the police. The most immediate and apparent concerns are job loss and stretching existing officers too thin, resulting in burnout.
Transitioning to a new model of policing needs careful consideration, since an abrupt shift in funding without a plan could result in risks to public safety, especially for the most vulnerable communities.
In the book, Ghettocide, Jill Leovy tells a compelling story of how the LAPD neglected murder investigations in poor, Black areas, resulting in significant risks to these communities where violent crime ran rampant. She writes:
“This is a book about a very simple idea: where the criminal justice system fails to respond vigorously to violent injury and death, homicide becomes endemic.”
This book demonstrates how “…gangs are a consequence of lawlessness, not a cause.” In neglected poor Black areas around LA throughout the ’80s and ’90s, gangs developed as an alternative form of security and commerce. She offers the following thought experiment to illustrate this situation:
“Take a bunch of teenage boys from the whitest, safest suburb in America and plunk them down in a place where their friends are murdered and they are constantly attacked and threatened. Signal that no one cares, and fail to solve murders. Limit their options for escape. Then see what happens.”
Leovy likens the criminal justice system to a “schoolyard bully”:
“It harasses people on small pretexts but is exposed as a coward before murder. It hauls masses of Black men through its machinery but fails to protect them from bodily injury and death. It is at once oppressive and inadequate.”
This nuanced view suggests structural racism is the result of over-policing minor infractions and under-policing homicide in these poor Black areas.
A recent popular tweet illustrates this tendency toward racialized over-policing:
“George Floyd died accused of using a counterfeit $20 bill. Remember when Brock Turner ACTUALLY raped an unconscious girl behind a dumpster, got 6 months of jail but only served 3 months bc of his “good behavior”? Yeah. White privilege is real.”
When considering defunding the police, it is essential to make sure resources are not taken away from homicide investigation in communities that are the most vulnerable.
A report by Harvard Economist Roland Fryer argues Good Policing Saves Black Lives. The key is to allocate resources to forms of policing that are the most effective while defunding areas that are the least effective.
A 2017 study on policing in New York in 2014 and 2015 analyzed the NYPD’s step back from proactive policing. Instead of going out to look for crime and stopping individuals for minor offenses, the department primarily waited for calls before responding.
Interestingly, this step back did not lead to increased crime rates, as one might expect. Instead, the 2017 study found:
“…civilian complaints of major crimes (such as burglary, felony assault and grand larceny) decreased during and shortly after sharp reductions in proactive policing.”
Although correlation does not equal causation, and this is only focused on one department over a brief period, the results are worth considering.
This move by the NYPD is the exact opposite of the case previously described in Ghettocide. In those poor Black areas plagued by gang violence, the police were harsh on petty crimes but unresponsive to major ones. The step back from proactive policing in New York stopped actively seeking out petty crimes and instead responded more readily to major ones.
Simply reducing police capacity altogether could result in increased gang activity in the most vulnerable areas to fill the void in social regulation. To reduce the risk of constraining police capacity to respond to violent crimes, it is crucial to consider only cutting specific forms of policing.
Since most crime is concentrated in a small number of hotspots, resources could be allocated in a targeted way, taking direction from the “law of crime concentration.”
Criminologist, David Weisburd, suggests “hot spots policing” is the most effective use of resources since 50% of crime occurs in 4% of street segments, with 25% of crime occurring in less than 1.5% of street segments. Reallocating resources accordingly could reduce the risks involved in defunding.
Is defunding the police a good idea?
Defunding the police may be a good idea if resources are effectively reallocated to preventative measures and mental health first-responders. Defunding the police may also come with risks to public safety if funds are not sufficiently reallocated.
We are in the midst of a unique moment where long-needed police reforms are actively being considered. With Minneapolis council members vowing to disband its police, the political motivation to go beyond band-aid solutions finally exists.
Although the words “defund” and “disband” are powerful, they can also be misleading. The general call for defunding refers to budget cuts for police departments and reinvestment in communities, not blanket abolition of all forms of policing activity.
Disbanding a police department is nothing new. In Camden, New Jersey, in 2012, the entire police force was laid off and reformed with a new mission toward community policing. The culture of that department was radically transformed. Since then, there has been a steady drop in crime and increased public trust in the police.
Here is a powerful short documentary on the story of Camden, New Jersey: Camden’s Turn: a story of police reform in progress.
I am optimistic that the recent protests have sparked real change, many of which are already being deliberated by city councils. Although these are challenging times, there is hope. The “defund the police” movement gives policymakers a specific, actionable goal: more effectively allocating policing budgets.
We must then carefully consider how to reinvest the funds to build healthier communities, increasing mental health first-responder capabilities, and supporting community policing initiatives to rebuild public trust.
Adjusting budgets will not solve everything, but it is a start. It forces departments to take a look at the research on what works, evaluate what is not working, and reallocate resources to best serve the goal of public safety.
Like this article? Join the mailing list to receive email updates when new ones are published:
by Steve Rose | Mar 31, 2020 | Suicide and Mental Health
On the go? Listen to the audio version of the article here:
The self-help genre has popularized positivity as being the superpower of personal development.
We’ve been told we can overcome anything by just thinking positive. Motivational messages from Instagram gurus tell people who are suffering to simply change the way they are feeling as if it were as easy as changing the channel.
Are you suffering from negative thoughts and tired of being told to “just get over it”? Have you tried changing your thoughts without being able to control how you feel? If you’ve tried all of the feel-good self-help methods or advice of well-intentioned coaches and haven’t seen any results, this article will explain why.
Do positive affirmations work?
Positive affirmations do not work for persons trying to boost self-esteem, change negative thoughts, or escape from painful emotions. The evidence suggests positive affirmations only work in individuals who are already positive or high performing.
In this article, I take a closer look at the psychological literature on the effectiveness of positive affirmations.
I conducted a brief literature review using Google Scholar. I then sorted through the studies based on their major findings, showing when positive affirmations don’t work vs. when they do work.
After exploring when they work and when they don’t work, I provide a more effective alternative to positive affirmations.
Each study is hyperlinked in their title text if you’re interested in further exploration.
Also, if you or someone you know is struggling with mental health issues, you can check out my resource page for suggestions on how to find help.
When Positive Affirmations Don’t Work
Affirmations don’t work when people need them the most.
According to Steven Hayes in A Liberated Mind:
“A recent study showed that positive affirmations like “I’m a good person!” work great as long as we don’t really need them. When we do need them, like when we start feeling bad about ourselves, such affirmations make us both feel and do worse! It’s a cruel joke.”
After tracking down the study cited above, I was able to confirm this finding. The study is titled, Positive Self-Statements: Power for Some, Peril for Others, and the researchers state:
“Positive self-statements seemed to provide a boost only to people with high self-esteem—those who ordinarily feel good about themselves already—and that boost was small.”
Affirmations don’t work when trying to escape from negative thoughts.
Why is this the case? According to the previously cited study:
“…if people who believe that they are unlovable repeat, ‘‘I’m a lovable person,’’ they may dismiss this statement and perhaps even reinforce their conviction that
they are unlovable.”
If you don’t believe a positive statement about yourself, trying to convince yourself through positive affirmations is like arguing with your brain.
How does your brain respond to arguments? No different than anyone else.
Have you ever tried to change someone’s mind by arguing with them? How did that work out for you?
Let me guess… they immediately changed their mind after rationally weighing the merits of your argument.
Or not.
More likely, they argued back even harder and more aggressively.
Just like everyone else, our mind doesn’t respond well to arguments. It digs its heels in and fights back. Trying to beat your mind into submission with relentless positivity will often backfire, further entrenching it in negativity.
Affirmations don’t work to improve your mood.
In another study titled When Self-Help Materials Help, the researchers found positive affirmations lowered the mood of individuals whose needs were not being met:
“…we found that participants experienced negative mood change after reading positive self-statements, if they have low level of need satisfaction.”
The researchers then compared reading positive statements to listening to them. Interestingly, they actually found a difference:
“…participants experienced a mood boost after listening to positive self-statements…”
They concluded that reading the positive statements caused participants to process it more deeply, causing them to reject it when not in alignment with their existing self-concept, whereas listening to positive statements allows for a more superficial level of processing.
Based on these mixed findings, the authors state:
These findings suggest that self-help materials with a focus on positive self-statements should be used with caution.”
Since positive affirmations don’t work the way we expect, we need to be careful about how we use them so they don’t backfire.
Let’s take a closer look at the research showing how positive affirmations can sometimes work in specific situations.
When Positive Affirmations Work
Affirmations can work if they facilitate social pressure.
In an article titled Social Standard Setting, the researchers had children watch videos teaching them positive affirmation techniques to overcome their fear of the dark. These affirmations seemed to help the children stay in a dark room longer than children who did not use these techniques.
Does this mean the affirmations worked?
The researchers then reran the experiment, with the children not knowing they were being observed as they learned these affirmation techniques. The improvements in coping with the dark immediately went away!
When learning these affirmation techniques in front of the researchers, the children performed better due to social pressure.
The researchers state:
The results are interpreted as showing that in this situation these therapies were effective due to specific social influence mechanisms. When public, the treatments appeared to set up social criteria for improved performance.
Therefore, the children weren’t performing better due to the content of the positive affirmations, themselves.
Although the affirmations were not the direct mechanism leading to improved performance, they were a secondary mechanism leading to social pressure that can improve performance.
Affirmations can work when focused on affirming your existing values.
Building on the results of the previously cited child study, I found another study that might offer further insight into how affirmations may work in relation to social pressure.
The study is titled The Impact of Self-Affirmation on Health-Behavior Change: A Meta-Analysis. The researchers found that affirmations focused on your existing values can lead to increased acceptance of positive health information and change in healthy behaviors:
“Self-affirmation inductions—such as questionnaires or writing exercises that remind participants of their important personal values—may have the potential to reduce defensive resistance to health-risk information.”
The researchers concluded:
“…deploying self-affirmation inductions alongside persuasive health information has positive effects, promoting message acceptance, intentions to change, and subsequent behavior.”
There is an element of social pressure involved here since the affirmations may increase the social pressure to remain consistent with one’s values and self-definition when subsequently receiving health information.
Beyond the social pressure, the study also shows how people strive to remain consistent with their own values and self-definitions.
In a counseling setting, this is perhaps the closest I come to using affirmations. Having someone clearly state their values is helpful by giving them a sense of direction, in addition to increasing motivation for change.
Although this might look a lot like affirmation, I would argue that it’s very different than the ineffective positive affirmation approaches described in the previous studies.
Reminding yourself of your core values in a statement such as, “I value authenticity,” is very different than trying to convince yourself of a specific identity you don’t currently hold.
Affirmations can help improve performance for athletes.
In a study titled, The Effects of Overt Head Movements on Physical Performance After Positive Versus Negative Self-Talk, the researchers found that combining positive affirmations with head-nodding improved performance among athletes:
“…positive self-statements led to better performance than negative self-statements
in 2 out of 3 physical tasks… self-statements are significantly more impactful on physical performance in the headnodding condition than in the head-shaking condition.”
So do affirmations work?
Recall the studies cited at the beginning of this article. Affirmations only work for those who don’t necessarily need them. They can be effective for persons with higher self-esteem and persons whose needs are already met.
Therefore, positive affirmations may work for athletes since they are likely already high performing. The affirmations are confirming their existing reality rather than trying to convince them of something they don’t believe.
Affirmations can work if focused on effort rather than competence.
Another study looked at the effect of affirmations on children with negative beliefs regarding their math abilities.
Titled, Effort Self-Talk Benefits the Mathematics Performance of Children With Negative Competence Beliefs, the study compared affirmations focused on ability, “I am very good at this!” with affirmations focused on effort, “I will do my very best!”. The study concluded:
“…effort self-talk benefited the performance of children holding negative competence beliefs: It severed the association between negative competence beliefs and poor performance. By internally asserting that they will deliver effort, children with negative competence beliefs can optimize their achievement in school.
This study confirms the idea that trying to convince yourself of something you don’t believe is not effective.
Rather than affirming a false reality, it is far more effective to affirm the fact that you will give the task your best effort.
This is a simple distinction between what you can control and what you cannot control.
We can control the amount of effort we put into a task, but we can’t immediately control how we think and feel about a task.
A Better Way to Cope with Negative Thoughts
Although affirmations can work, they only seem to work in particular situations. In my work as an addiction counselor, I don’t use positive affirmations because they are generally ineffective.
Persons suffering from addiction are often using a substance or behavior to cope with underlying pain or unmet needs. As seen in the literature, using positive affirmations to cope with these underlying issues often backfires.
Instead of using affirmations, there is a better way to deal with difficult thoughts and painful emotions.
If affirmations have not been working for you, it might be helpful to consider trying a strategy called acceptance and defusion.
Acceptance and defusion techniques come from Acceptance and Commitment Therapy (ACT), a therapeutic approach supported by over 330 clinical trials.
As described in my previous article on How to Stop Living in Your Head, you can use the following to more effectively cope with unhelpful forms of worry:
- Accept what you can’t control
- Step back from your thoughts
- Focus on the present moment
- Remove limiting self-definitions
- Live by your core values
- Take action toward what matters
Take a look at the full article if you are interested in exploring each of these areas in-depth, in addition to learning some practical exercises designed to gain a healthy perspective.
Summary
Positive affirmations don’t work for those trying to escape from negative thoughts or painful emotions. In fact, affirmations can often make the situation worse by reminding an individual they are not living up to the affirmation.
Like trying to change someone else’s mind by arguing with them, we can’t change our own that way either. Insisting we are happy and successful does not make us feel more happy or successful if we don’t already feel that way.
Affirmations can work to improve mood and performance among individuals who are already high functioning, such as athletes.
Specific types of affirmations can also work, including affirming your existing values or affirming the fact that you will give your best effort.
In general, a more effective approach to dealing with negative thoughts or difficult emotions includes accepting what you can’t control and taking a step back from your thoughts, as described in detail in my article on How to Stop Living in Your Head.
by Steve Rose | Mar 28, 2020 | Suicide and Mental Health
On the go? Listen to the audio version of the article here:
Approaches to mental health and addiction treatment have evolved significantly over the years.
Within the last couple of decades, the explosion of online resources further extended the availability of professional counselling and peer support.
This shift to online platforms has led many people to ask if online counselling methods work, or if traditional face-to-face approaches work better. I decided to dig into the academic literature on online counselling to answer the question.
Does online counselling work?
According to recent evidence, online counselling is effective for treating mental health and addictions. Multiple studies show it is generally as effective as face-to-face counselling and has the benefit of expanding access to mental health and addiction treatment.
Let’s take a closer look at the research.
Summary of Evidence for Online Counselling
The following consists of a summary of my brief review of the academic literature on online counselling.
Using Google Scholar, I searched for articles on the effectiveness of online counselling, studies comparing the effectiveness of online counselling vs. face to face counselling, and studies that particularly focus on addiction treatment.
Articles were not filtered based on their conclusions, and most of the studies included are systematic reviews and meta-analyses, meaning they are comprehensive studies of the studies themselves.
The major findings of each article are presented as excerpts, but you can click the title to view the full text.
Evidence for Treating Mental Health Conditions
Internet Interventions for Mental Health and Addictions: Current Findings and Future Directions
“There is considerable evidence for the effectiveness of Internet-based interventions targeting depression, anxiety disorders, alcohol use and smoking. Small to moderate effect sizes have been reported for interventions targeting depression, anxiety and alcohol use, and smoking interventions have shown large effects.”
A comprehensive review and a meta-analysis of the effectiveness of Internet-based psychotherapeutic interventions
“There was support for the application of psychotherapeutic interventions through the Internet; online therapy was especially effective for treating anxiety and stress-effects that lasted after therapy ended and on average was as effective as face-to-face intervention.”
Guided Internet‐based vs. face‐to‐face cognitive behavior therapy for psychiatric and somatic disorders: a systematic review and meta‐analysis
“…guided Internet‐delivered cognitive behavior therapy (ICBT) and face‐to‐face treatment produce equivalent overall effects.”
The Therapeutic Relationship in E-Therapy for Mental Health: A Systematic Review
“Although the results do not allow firm conclusions, they indicate that e-therapy seems to be at least equivalent to face-to-face therapy in terms of therapeutic alliance…”
Evidence for Treating Addiction
A systematic review of Internet-based therapy for the treatment of addictions
“The review concluded that Internet-based therapies for addictions are effective in achieving positive behavioral changes but that more research is required to determine the comparative effectiveness of various Internet-based therapies
and their components.”
Computer-Delivered Interventions to Reduce College Student Drinking: A Meta-Analysis
“…computer-delivered interventions (CDIs) reduce the quantity and frequency of drinking among college students. CDIs are generally equivalent to alternative alcohol-related comparison interventions…”
Technology-Delivered Cognitive-Behavioral Interventions for Alcohol Use: A Meta-Analysis
“These results show a benefit for technology-delivered, CBT-based interventions as a
stand-alone therapy for heavy drinking or as an addition to usual care in specialty substance use settings.”
A review of technology-assisted self-help and minimal contact therapies for drug and alcohol abuse and smoking addiction: Is human contact necessary for therapeutic efficacy?
“…self-administered and predominantly self-help computer-based cognitive and behavioral interventions are efficacious, but some therapist contact is important for greater and more sustained reductions in addictive behavior.”
Blending Face-to-Face and Internet-Based Interventions for the Treatment of Mental Disorders in Adults: Systematic Review
“Results suggest that, compared with stand-alone face-to-face therapy, blended therapy may save clinician time, lead to lower dropout rates and greater abstinence rates of patients with substance abuse, or help maintain initially achieved changes within psychotherapy in the long-term effects of inpatient therapy.”
Disadvantages of Online Counselling
In an article titled, Internet Help and Therapy for Addictive Behavior, by Mark Griffiths, PhD, he reviews some of the potential disadvantages of online counselling.
Legal and ethical considerations: It may increase the opportunity for unqualified or unskilled counsellors to market their services without proper oversight.
Confidentiality: As opposed to using paper records and in-person encounters, technological communications present an element of cyber-security risk.
Severity of client problems: Sensitive areas such as extreme trauma or grief counselling might be better conducted in person.
Client referral problems: If a client requires other types of services, a counsellor who is not from the same region will likely be unfamiliar with local resources for referral.
Establishing client rapport: Technological lag can sometimes result in unintended interruptions or requests to repeat statements, making natural rapport slightly more difficult.
Commercial exploitation: If you are visiting websites for online counselling, advertisers may be able to track your browser cookies, using the information to target advertising.
Convenience: The level of convenience could encourage dependency on the counsellor through frequent casual checking in rather than fostering client autonomy.
Advantages of Online Counselling
In the same article cited above titled, Internet Help and Therapy for Addictive Behavior, by Mark Griffiths, PhD, he also reviews some of the potential advantages of online counselling.
Convenience: This could encourage clients to enter treatment and maintain a regular focus on recovery that is logistically simple.
Cost-effective for clients: Clients who are not covered by insurance can often find lower prices by shopping around online. Note that it is not necessarily advisable to go for a bargain on this type of service. Also, note that expense is not always a guarantee of quality.
It overcomes barriers that otherwise prevent people from seeking face-to-face help: For someone suffering from extreme social anxiety or agoraphobia, online counselling can be a way to begin an effective therapeutic relationship.
It helps overcome social stigma: Rather than having to enter into a facility or attend a meeting in-person, clients can gain further anonymity.
It allows therapists to reach an exponential amount of people: Online counselling provides increased access to treatment, particularly for rural clients or clients with unique conditions requiring specialized practitioners.
In general, the evidence for online counselling is somewhat preliminary but shows great promise as an effective approach for treatment.
by Steve Rose | Mar 22, 2020 | Addiction and Recovery, Suicide and Mental Health
In light of Covid-19, I’ve been thinking about the role of worry in our lives. As anxiety, uncertainty, and social isolation ramp up, we need to take care of our mental hygiene as well as our physical hygiene.
From panic shopping to media obsession, there is no shortage of worry going around. This new situation led me to become curious about how worry impacts our mental health.
Is worrying helpful?
Worrying can be helpful or harmful, depending on the type of worry. It is helpful when focused on practical short-term actions, but it is harmful when focused on abstract ideas about the future that lead to repetitive thoughts and inaction.
Let’s take a closer look at what this means and how you can keep your worrying in check.
What is Worry?
Researchers Kate Sweeny and Michael D. Dooley state:
“Worry is an aversive emotional experience that arises alongside repetitive unpleasant thoughts about the future.”
In simple language, worry is unpleasant emotions and thoughts about the future. These thoughts begin to act like a broken record, replaying the same lines over and over.
The emotion is usually fear, and the thoughts generally involve catastrophic scenarios—for example, a pervasive fear regarding the thought of potentially being infected by a virus.
Having this worry may be helpful, or it may be unhelpful, depending on the extent of the worry and the actions that follow. Let’s take a closer look at the research on helpful forms of worry.
Helpful Forms of Worry
A study titled The Surprising Upsides of Worry found that worrying acts as a motivator to take helpful precautionary measures. The researchers state:
“It also triggers efforts to mitigate the consequences of bad news, motivates productive behavior that in turn reduces worry, and enhances the effectiveness of goal‐directed action by prompting people to focus on obstacles that might derail best‐laid plans.”
People who worry more are more prepared and less likely to face risks in many areas of life.
A 2014 study found that people who worry more about skin cancer are more likely to wear sunscreen. A 2006 meta-analysis of the evidence found that women who are more worried about breast cancer are more likely to get screenings. Lastly, a 1990 study found that people who are more worried about getting an injury in an automobile accident are more likely to wear a seat belt.
In addition to motivating helpful preventative measures, worry can also act as an emotional buffer to adverse outcomes. This means you are less disappointed when things don’t go well. According to the researcher who conducted the study on the Upside of Worry:
“If people’s feelings of worry over a future outcome are sufficiently intense and unpleasant, their emotional response to the outcome they ultimately experience will seem more pleasurable in comparison to their previous, worried state…”
Worry lowers expectations about future outcomes, leading to better emotional states when things go better than expected.
Although worry has its benefits, it needs to be kept in check. Let’s take a closer look at the research on unhelpful forms of worry.
Unhelpful Forms of Worry
Unhelpful forms of worry are quite common and can cause an upward spiral of negative thoughts and uncomfortable emotions, leading to paralysis.
In an in-depth review titled, Constructive and Unconstructive Repetitive Thought, Edward R. Watkins states:
“…worry characterized by a concrete level of construal is constructive, whereas worry characterized by an abstract level of construal and negative intrapersonal context (e.g., low problem-solving confidence) is unconstructive.”
This finding means worry is productive when focused on practical actions and unproductive when worrying about large scale issues without a focus on concrete actions.
Unhelpful forms of worry are focused on repeatedly thinking about issues beyond your control. Since you cannot do anything about issues beyond your control, your mind pretends to be busy by worrying. Worrying feels productive when it is doing nothing to solve the problem.
Mary Schmich illustrates this when she states:
“…worrying is as effective as trying to solve an algebra equation by chewing bubble gum.”
Beyond not being useful, this type of worrying can be detrimental to your health, according to WebMD:
“Chronic worrying can affect your daily life so much that it may interfere with your appetite, lifestyle habits, relationships, sleep, and job performance. Many people who worry excessively are so anxiety-ridden that they seek relief in harmful lifestyle habits such as overeating, cigarette smoking, or using alcohol and drugs.”
When worry becomes pervasive and harmful to areas of your life, it may be helpful to consider whether you are using worrying as a way to feel busy. Although it gives the illusion of control, this type of worrying takes away your ability to take control.
When worry hijacks your brain, your fight or flight response turns on, reducing activity in the higher evolved prefrontal cortex, the area associated with control over one’s behavior. When worry spirals out of control, it leads to intense fear and paralysis.
In addition to limiting one’s ability to take practical actions to reduce the worry, it narrows one’s ability to move toward any valued directions in life.
Luckily, if you find yourself falling into this form of unhelpful worry, there are things you can do to regain balance.
How to Cope with Unhelpful Worry
As described in my previous article on How to Stop Living in Your Head, you can use the following to more effectively cope with unhelpful forms of worry:
- Accept what you can’t control
- Step back from your thoughts
- Focus on the present moment
- Remove limiting self-definitions
- Live by your core values
- Take action toward what matters
Take a look at the full article if you are interested in exploring each of these areas in-depth, in addition to learning some practical exercises designed to gain a healthy perspective.
Summary
Worrying can turn you into the slave of your thoughts and emotions. It can also motivate you to take necessary preventative action. Some worry is better than none, but too much worry can cause more harm.
Helpful forms of worry consist of short-term concrete actions, whereas unhelpful styles of worry include abstract catastrophic thinking leading to paralysis.
If you find yourself engaging in unhelpful forms of worry, it is also unhelpful for someone to simply tell you to stop worrying. If it were that easy, psychologists and addiction counselors would not exist.
by Steve Rose | Mar 14, 2020 | Suicide and Mental Health
On the go? Listen to the audio version of the article here:
Are you stuck in your head, over-analyzing everything, replaying the same thoughts like a broken record? Are you unable to focus on what matters, zoning out, or becoming socially withdrawn because of racing thoughts often starting with “what if…?”.
“What if I’m not good enough? What if I didn’t do that report properly? What if I fail this class and don’t graduate on time?”
Living in your head can feel like being controlled by a dictator, keeping you from living a life of purpose and connection.
So how do you stop living in your head?
- Accept what you can’t control
- Step back from your thoughts
- Focus on the present moment
- Remove limiting self-definitions
- Live by your core values
- Take action toward what matters
This information is based on the principles of Acceptance and Commitment Therapy (ACT), supported by over 330 clinical trials.
Let’s take a closer look at each of these principles and how they can help you get out of your head.
Also, if you or someone you know is struggling with mental health issues, you can check out my resource page for suggestions on how to find help.
Accept What You Can’t Control
When you are living in your head, you are often attempting to control things outside your control through over-analysis. The problem-solving mind thinks it has all of the solutions, leading to constant thinking.
“I can’t feel this way… I need to fix this… I can’t stand this!”
Although your rational mind is useful when doing logical things like fixing a car or doing financial reports, it is unhelpful when dealing with uncomfortable emotions.
As Russ Harris states:
“Stop trying to control how you feel, and instead take control of what you can do”
Acceptance of what you cannot control opens you up to the discomfort of uncertainty but liberates you from the eternal battle with your mind.
A common ACT metaphor is the Chinese finger trap. The harder you pull, the tighter it gets. Your mind works the same way. Try convincing your mind of something and you will quickly hear the mind’s counter-arguments.
You can continue the battle with the rational mind at the expense of less and less freedom to remain fully engaged in meaningful activities.
To use another common ACT metaphor, imagine you find yourself on quicksand. Your natural reaction might be to run or struggle. The more you do this, the faster you will sink.
A more effective approach is to lay down and make as much contact with the quicksand as possible. This increases your surface area, preventing you from sinking.
Here is a simple exercise designed to help you practice acceptance skills with your own forms of mental quicksand:
Think of a memory or thought you find yourself avoiding.
For the next minute, simply make room for the discomfort, noticing the specific sensations that come up. Where are these sensations located in your body? What emotions come up? What is your mind telling you about these sensations? Curiously tune into what is going on, noticing and making space for it.
Like the quicksand, the purpose of this exercise is to willingly make contact with the difficult area, allowing you to stop the pattern of avoidance that keeps you locked in an unnecessary and unproductive battle.
Step Back From Your Thoughts
It is easy to become entangled with your thoughts, trapped as they distort everything you see. A good day can be easily ruined by a bit of criticism, sparking a forest fire of negative thinking.
“I can’t believe he cut me off!… This is not fair!… I’m going to teach him a lesson!”
In order to stop this cascade of catastrophic thinking, take a step back from your thoughts, distinguishing the metaphorical forest from the trees.
When you step back and notice a thought, you are no longer entangled in it, giving you the freedom to choose what you want to do rather than simply reacting to the thought.
As stated by ACT founder Steven C. Hayes:
“What we need to learn to do is to look at a thought rather than from thought.”
This is especially useful when you notice common thought patters. For example, the thought “I’m not good enough” might show up every time you give a presentation. Rather than fusing with the thought, you can notice it, thank it for helping you stay prepared, and continue to give the presentation anyway.
Thoughts only have power over you if you buy into them as real. Like the Wizard of Oz, noticing a thought as just a thought is like revealing the harmless man behind the curtain.
Here is a simple but powerful ACT exercise called “do the opposite”, designed to develop distance between you (the observer) and your thoughts:
If you are currently sitting down, repeat to yourself, “I can’t stand up” several times. As you continue telling yourself you can’t stand up, simply stand up.
You can do these exercises with any thought. Notice what your mind is saying you can’t do, make space for that thought, and simply do the opposite. There is no need to argue or struggle with the thought. Just notice the thought, acknowledge its presence, and take it with you.
Focus On The Present Moment
When living in your head, most of your time is likely spent thinking about the past or worrying about the future.
“Did they misunderstand what I said the other day?… Will they be upset?… Did I make a mistake?… Will I regret this?
Notice how quickly these statements flip from the past to the future. They focus on everything but the present moment.
Although focusing on the present moment helps you stop living in your head, there is a time for thinking about the past or the future. Without this ability, we wouldn’t be able to learn from mistakes or plan for the future. The problem occurs when these thoughts become so frequent that they begin interfering with your life.
As Lao Tzu said:
“If you are depressed you are living in the past. If you are anxious you are living in the future. If you are at peace you are living in the present.”
Although this is a bit of a generality, it is important to refocus your attention on the present moment when the past or future thinking is no longer helpful.
So what does it mean to be focused on the present moment? Daniel J Siegel states:
“Mental presence is a state of being wide awake and receptive to what is happening, as it is happening in the moment, within us and between the world and us. Presence cultivates happiness.”
When you live in your head, you lose touch with the present moment. This creates a barrier between you and the world by preventing you from noticing opportunities for connection. It also prevents you from noticing the beauty in simple everyday things.
Here is an exercise you can do to practice getting out of your head and getting back in touch with the present moment:
If you are sitting down, bring your attention to the sensations in your body. Notice the sensation of your back or legs against the surface.
Now bring your attention to your feet, noticing how they feel against the surface they are resting on.
Now notice the sensation of your breath. Feel the rise and fall for a few moments. You may even now be aware of your heartbeat.
When you’re ready, bring your attention to your face. Notice any tension in your jaw, and simply let it go. You can then bring your attention to the sounds (or silence) around you. Notice the details of any sound. Listen to any sounds curiously, as if listening to a fine piece of music.
Now you can take a few moments to look around, curiously noticing the textures, colors, shapes, and placement of the things around you.
Any time you find yourself getting stuck in past or future thinking, take a moment to ground yourself in one of these areas. Some people find starting with the breath to be the most effective, whereas others prefer focusing on a body part like the feet.
Remove Limiting Self-definitions
Living in your head often results in excessive concern regarding self-image.
“Will they like me?… Am I good enough?… Am I smart enough?”
When you apply rigid labels to yourself, you are limiting your ability to connect with others. Holding too tightly to labels about yourself puts you into social comparison mode. Being “not good enough” implies self-comparison to a made-up standard.
These made-up standards could be ones portrayed by the media, or they could be learned early on in childhood. Either way, you take on the voice of that standard, criticizing yourself for never living up to it. The problem is that this standard is constantly out of reach like a donkey chasing a carrot on a stick.
Although it is tempting to replace the negative self-concepts with positive ones, these can be limiting and disconnecting too.
Positive rigid self-definitions contribute to social comparison and disconnection, similar to negative ones. For example, needing to identify as smart requires your mind to constantly justify this sense of smartness by comparison to others. This social comparison causes a sense of disconnection from others.
Rigid self-definitions are the ego’s armor, protecting a fragile underlying sense of self. Rather than countering low self-esteem with positive affirmations and false high self-esteem, opting out of this process altogether is more effective, helping you get out of your head and connect more deeply with others.
As stated by Eckhart Tolle in A New Earth:
“Give up defining yourself – to yourself or to others. You won’t die. You will come to life. And don’t be concerned with how others define you. When they define you, they are limiting themselves, so it’s their problem. Whenever you interact with people, don’t be there primarily as a function or a role, but as the field of conscious Presence. You can only lose something that you have, but you cannot lose something that you are.”
Here is a metaphor from The Big Book of Act Metaphors you can use if you find yourself getting trapped in self-critical or grandiose thinking:
You are the sky and your thoughts are the weather. Clouds may come and go, become turbulent or calm, but no matter what happens with the weather, the sky above remains blue and unchanged. No matter how bad the weather, the sky always has room for it. When the clouds become thick and stormy, we may forget the sky is still there, but like flying in an airplane, when we rise above the cloud-line, the sky is clear, stretching in all directions.
You are not your thoughts. Rather, you are the awareness of your thoughts. Like the sky, you are the space that contains the thoughts. They can come and go like the weather, but remaining connected to the sense of yourself as an observer allows you to more flexibly act according to your values.
Live By Your Core Values
When you are living in your head, comparing yourself to others, you begin to live by external values rather than your own.
“Am I doing this right?… Am I doing enough?… Am I going to be successful?”
The media bombards us with messages that success means having money, power, privilege, or beauty. This false image of success keeps us always looking for more. Bigger, better, smarter, faster, stronger, more attention, more stuff! The more we get, the more we want.
So what is the true meaning of success?
It means living in alignment with your personal definition of success by taking meaningful actions in line with your values. A stated by Russ Harris:
“Success in life means living by your values.”
When living in your head, it is easy to get distracted by external definitions of success. External definitions of success give you a hollow goal, void of a deep sense of purpose.
Values are distinct from goals since they provide a sense of meaningful direction and do not have an end-point. Goals are finite, whereas values can be drawn on indefinitely, acting as a compass for action.
Here is a quick practical ACT exercise designed to help you get in touch with your personal values:
Imagine you have a mind-reading machine that can tell you the thoughts of someone close to you. Tune in to what that person is thinking about you. What are they thinking about what you stand for? What do they think are your personal strengths? What do you mean to this person? In an ideal world where you are the person you want to be, what do you hear this person thinking?
What theme do you see?
Come up with a few core values and keep them with you throughout the next week, being mindful of how they inform your actions.
Some examples of values include compassion, creativity, authenticity, community, order, justice, courage, curiosity, and loyalty.
Simply put, values are a way of being.
Rather than second-guessing yourself and worrying about what others are thinking, getting out of your head requires being mindful of your values, and acting in accordance with them.
Rather than getting lost in your thoughts, you can ask yourself one simple question: did I act in alignment with my values?
Take Action Toward What Matters
When living in your head, it is easy to procrastinate, hoping for some ideal time to take action.
“I’m just not ready yet… what if I fail?… am I an impostor?
This is the realm of perfectionism. When your desire for competence becomes distorted, you constantly question whether or not you are ready to take action. Impostor syndrome can take over, and you feel like you are a fraud.
When stuck in a state of analysis paralysis, we stall our efforts to take meaningful action toward what matters. So how do you get out of your head and begin to build behavioral momentum? The key is building habits into your daily routine. As Aristotle stated:
“We are what we repeatedly do. Excellence, then, is not an act, but a habit.”
The most effective way to build new behaviors is to slowly integrate new patterns of action into your daily routine.
Here is a practical guide to getting out of your head by incorporating meaningful behaviors into your life:
- Consider one of your core values from the previous exercise.
- List some new actions you can take to bring this value into the world.
- Create a goal for a specific action based on the SMART principle:
– Specific: Is this a specific goal, or is it too broad?
– Measurable: How would you measure progress toward this goal?
– Achievable: Is this a realistic goal?
– Relevant: Is this meaningfully connected to your values?
– Time-bound: What is your timeline/ deadline for this goal? - Consider where you can slot this new action into your daily routine.
- Consider ways of amplifying this action within your routine over time.
- Continue to remind yourself how this action is based on your specific values.
Conclusion
Getting out of your head requires accepting what you can’t control, stepping back from your thoughts, focusing on the present moment, removing limiting self-definitions, living by your core values, and taking action toward what matters.
In short, it means letting go of the dictator within, reconnecting with your core values, and acting in alignment with those values.
Letting go of the dictator can help you gain freedom from addictions (notice the commonality between the two words). Addictions to alcohol, substances, gambling, gaming, the internet, or work are ways to turn the mind off and temporarily escape the dictator within. When you escape the dictator through these short-term methods, it comes back with a vengeance, leading to longer-term consequences and even stricter rules.
Trying to fight the dictator within only leads to a futile tug of war. You spend all your time struggling while the meaningful moments pass you by. The ACT techniques described in this article are designed to help you drop the rope.
This is not meant to be an easy process. Working on getting out of your head requires a degree of short-term discomfort that can lead to longer-term freedom.
You can undertake this process yourself or with the support of a mental health or addiction specialist who can partner with you on the journey.
