Lecture 6 & 7 Mental Relaxation Part I & II

Lecture 6 & 7Mental Relaxation Part I & II Dr. Paul Wong D.Psyc.(Clinical) E-mail: paulw@hku.hk Centre for Suicide Research and Prevention (CSRP)

Outline • A small summarization of the last few lectures • Introduction of a research on relation between automatic thoughts and level of stress • The Cognitive approach to external stressor in daily life - ABC model • Mental relaxation • “Questioning your thoughts” exercise – with a little extra more work

In English Stress is the reaction people have excessive pressures or other types of demand placed upon them. It arises when they worry that they can’t cope.

External Stressors e.g., demand at work, relationship breakup Behavioural Reactions e.g., aggression, escape Cognitive Processes e.g., appraisal of threat, expectations of coping or not, and consequences Emotional Reactions e.g., anxiety Physiological Reactions e.g., insomnia, increase heart rate, increase blood pressure Essential Components of Stress

A little recap: Sources of Stress External Internal

External Stressors • Physical Environment (Noise, Bright Lights, Heat, Confined Spaces) • Social Interaction (Rudeness, Bossiness, Aggressiveness by others, Bullying) • Organizational (Rules, Regulations, Deadlines) • Major Life Events (Birth, Death, Lost job, Promotion, Marital status change) • Daily Hassles (in-class exercise – Sarafino & Ewing (1999) – Hassles Assessment Scale for Students in College)

Internal Stressors • Negative self - talk (Pessimistic thinking, Self criticism, Over analyzing) • Mind traps/Thinking errors (Unrealistic expectations, Taking things personally, All or nothing thinking, Exaggeration, Rigid thinking) • Personality traits (Perfectionists, Workaholics)

Types of Stress • Negative stress (dy-stress) • Positive stress (eu-stress)

Note: Most of the stress we experience is self-generated. How we perceive life - whether an event makes us feel threatened or stimulated, encouraged or discouraged, happy or sad - depends to a large extent on how we perceive ourselves.

Introduction • Stress is subjective • Cognitive interpretations of stressor directly affect level of stress Negative Automatic Thoughts (NATs) – are likely to be the causes of stress

What research told us? • Methodology • Subjects: 197 male and 283 female • Automatic Thoughts Questionnaire – Positive (ATQ-P) • e.g. “I am a lucky person”, “Life is exciting” • Automatic Thoughts Questionnaire – Negative (ATQ-N) • e.g. “I am a loser”, “I am no good” Source: Ingram, R.E., & Wisnicki, K.S. (1988). Assessment o positive automatic cognition. Journal of Consulting and Clinical Psychology, 56, 898-902.

Result Note: For ATQ-P, the higher the score the higher level of positive thinking For ATQ-N, the higher the score the higher level of negative thinking Source: Ingram, R.E., & Wisnicki, K.S. (1988). Assessment of positive automatic cognition. Journal of Consulting and Clinical Psychology, 56, 898-902.

Discussion • The ABC model of Ellis’s theory A : the activating event B : the individual’s belief C : the response or consequence B A C • Cognitive appraisal varies from person to person  different stress level facing the same event Source: Gillis, J.S. (1992) Stress, Anxiety, and Cognitive Buffering. Behavioral Medicine,18(2), 79-83

Discussion A Stressor B Automatic thoughts C Stress level

Conclusion of this research • Positive Automatic Thoughts (PATs) act as a stress buffer • Negative Automatic Thoughts (NATs) exaggerate effects of stress • Possible solution: • Thinking from a different perspectives

Reference • Gillis, J.S. (1992) Stress, Anxiety, and Cognitive Buffering. Behavioral Medicine,18(2), 79-83. • Ingram, R.E., & Wisnicki, K.S. (1988). Assessment of positive automatic cognition. Journal of Consulting and Clinical Psychology, 56, 898-902. • Lightsey, O.R. (1994) “Thinking Positive” as a Stress Buffer: The role of positive automatic cognitions in depression and happiness. Journal of Counseling Psychology, 41(3), 325-334. • Taylor, S. E. (1995). What is stress? In S. E. Taylor (Eds.), Health Psychology (pp.219-254). Singapore: McGraw-Hall.

Mental Relaxation

Rationale • Relaxation is one of the popular approaches to stress-management, but people do tend to focus on physical relaxation • Physical relaxation is helpful because “it makes people feel good at the time” • However, “I feel wonderful at my yoga class, but once I go back to my home, I feel tense and worry again!!”

External Stressors Behavioural Reactions Cognitive Processes Emotional Reactions Physiological Reactions

Caution: • We don’t need to practice this mental relaxation every time when we are sad or upset, • But, we use it when we have very strong and prolonged bad feelings • Thus, our target in mental relaxation is exaggerated bad feelings.

Six Steps in Mental Relaxation • Get in touch with your feelings • Accept that you can cope with bad feelings • Reward your successes • Try to identify your self-talk • Test your self-talk • Teach yourself to think rationally

First three steps vs. last three steps • The first three steps we do them on the spot to help us cope with our bad feelings there and then; • Whereas, the last three steps we do them later, when we have the time to review the situation, as to prepare ourselves to cope better in the future.

1. Get in touch with your feelings • This can be trickier than it looks • i.e., men tend to deny bad feelings because men should be tough and can take on any sufferings, right?! • It is easy to mix up “feeling” and “thought” • - “I feel nervous” vs. “I feel that I am going to fail the exam” • Then give yourself a rating from 0-100% of how intense is the feeling

Angry Frustrated Upset Hurt Disappointed Hopeless Regret Mad Unhappy Worried Confused Tense Fearful Down Depressed Bitter Disgust Restless Embarrassed Jealous Envious Anxious Guilty List of common bad “feelings”

2. Accept that you can cope with bad feelings • “I just can’t cope”, “I have no choice”, “I can’t hold it anymore” etc. • We are talking about “feelings” here, not the cause/stressor yet. • A general coping statement which we can tell ourselves: “I expect to feel (feeling) (in a situation) but I can cope with feeling (that feeling). So I won’t deny my feelings, but I won’t exaggerate them either. Is there something constructive I can do to improve the situation/ If there is, I’ll plan it now and do it. If there isn’t, I am not going to make myself feel worse than is reasonable. Now, what will I do instead?”

3. Reward your successes • If you can break the automatic ABC cycle, and making yourself feel less negative, you have done a wonderful job to yourself. • E.g., you started to feel 95% anxious when you was asked to do a presentation in front of 250 people. Then, you stopped your negative thought by telling yourself a coping statement in your head that you will find out ways to handle this request, and now you are feeling 75% anxious, then, you have done something for yourself already. • Then you can reward yourself by giving yourself “a pat on the pack” or “self-congratulations”.

4. Try to identify your self-talk/automatic thought • Self talk = the first sentence/picture that comes into your mind • Once again, not as easy as we think • “ I don’t have any thoughts!” • “ I have been thinking like that since I was very young, and I just can’t change.” • REMEMBER – the self-talk or automatic thought is the FIRST statement or picture that come into your mind. • E.g., when being asked to do a presentation for 250 people, my first picture that comes into my mind is “I am speechless when someone asks me a question, and I stand there for 2 mins scratching my head and have nothing to say” • or “I have been a lousy speaker”.

5. Test your self-talk • Now we go to the most challenging part – matching our automatic thought with the thinking error; • This step is to test out how realistic or reasonable our self-talk is and try to look at it critically to see if we are making any of these common thinking errors.

Thinking errors • Common mistakes in Thinking: I short-listed 6 of them • Overgeneralizing – e.g., if you fail once, you will fail forever • Black-and-White Thinking – e.g., being in love must be very good, otherwise it is very bad • “Who needs evidence?” – e.g., people don’t like me • Looking at the world through deep blue glass – e.g., I fail an exam, and I must be stupid • Imaging the worst – e.g., I fail an exam, I must be stupid, and I will never graduate • Taking things personally – e.g., the company did not make as much revenue as the previous years, I must be the one to be blamed.

E.g., I am a lousy speaker • Thinking errors that I am making • Overgeneralising “just because it happened in 2-3 classes out of 100 classes I did, does it mean that it apply to every class I teach?! No!” • Imaging the worst “well, maybe I can answer all questions easily!”

6. Teach yourself to think rationally • Exercise – “Questioning your thoughts” with a bit more details this time

Paul’s demonstration • Get in touch with your feelings • Accept that you can cope with bad feelings • Reward your successes • Try to identify your self-talk • Test your self-talk • Teach yourself to think rationally • The incident -

Briefly describe the problem: … • And how it makes you feel: (give a 0-100%) … • And what you think about it: (the automatic thought) … • Can I cope with this feeling? … • What is the evidence that supports your thoughts? … • What is the evidence against your thoughts? … • Is there an alternative explanation of what happened? …

What is the worst that could happen? … • Could you live through it? … • What is the best that could happen? … • What is the most realistic outcome? … • What is the effect of believing my original thought about this? … • The thinking errors: … • What could be the effect of questioning those thoughts?

What should I do about this problem? … • What would I say to a friend if s/he were in the same situation? …

Introduction of Irrational Beliefs • The concept of Irrational beliefs was proposed by Dr. Albert Ellis; • He suggests that all psychological problems arise from irrational thinking; • Thus, solving all psychological problems involves changing our irrational thinking to be more rational; • He suggests that there are 10 common irrational beliefs.

Straight Thinking Exercise • Describe the situation triggering your bad feelings: • Describe your bad feelings: • What do you think or imagine about the situation? Not sure? Guess. • Which thinking errors can you find in your thouights about the situation? • Which irrational beliefs are influencing your reaction to this situation?

Lecture 6 & 7 Mental Relaxation Part I & II