Cognitive Therapy

1. Cognitive Therapy Understanding how a thought turns into ocd

2. Irrational beliefs • Overimportance of thought • Control of thoughts • Overestimation of danger • Desire for certainty • Responsibility • Perfectionism • Consequences of exciting • Fear of positive experiences

3. The OCD within you is like that drunkard • Do not answer him • Do not prove him wrong • Do not try to understand him • Do not fight with him • Do not analyze him • Do not be afraid or intimidated by him • Do not avoid him Treat him like what his true value is: a worthless drunkard, not worthy of the slightest bit of attention

4. However, it is worth investing A one-time investment to analyze this style of thinking, and the corruption within it. Then learn the pattern that he uses and defy it. 1) Preferably do it together with someone else who understands anxiety. 2) Plan a time to do it, only analyze the anxious or ocd thoughts when you set the time to do it, not when it comes on its own

5. Which beliefs fuel my OCD? • Take inventory of the uncomfortable thoughts that plague you and see which of these beliefs are the pattern of your thought process. • Notice how the way these beliefs play a role in building your anxiety. • Understand that the drunkard thinks with this irrational set of beliefs and how you should be responding to him.

7. Follow the pattern that is a result of these irrational beliefs. • Ocd is a voice within you but its not you • Ocd is not rational – it works with a different set of rules. • Take inventory of your personal ocd • Search which irrational beliefs apply to you • Match it to the ocd being fueled with those false beliefs • Now that you see that its wrong and has no logic don’t be afraid to defy it. • Since it doesn’t agree with basic logic, you can’t use logic against it – so treat like an illogical drunk

8. We will now focus more specifically on how to recognize your fears, understand them, and see what is irrational in them. There are various cognitive techniques to use to accomplish this.

9. The downward arrow Most fears are built on a series of thoughts that build one on top of another and each one increases the intensity of the fear It is important to recognize the different parts so that you can actually see how irrational the beliefs really are

10. Most fears begin with a slight fear of discomfort and end with the fear of severe catastrophe I have a feeling that I may not be able to sleep tonight 1 - I am afraid I will not be able to fall a sleep tonight 2- If I do not sleep well tonight – then I will not be able to concentrate tomorrow during seder 3 – if I will not concentrate during seder my Chavrusa will not want to learn with me, he will get annoyed with me.

11. 4 – if my Chavrusa will not want to learn with me, he will get annoyed with me. – than he will dump me • 5 – if he will dump me, everyone will realize that I’m not a good learner. • 6 – if , everyone will realizes that I’m not a good learner Then I wont be able to get good Chavrusos, • 7 - I will become like all those nebachs that are famous in town.

12. 8 –if I won’t be able to get good Chavrusos than I won’t succeed in learning • 9 – if I won’t succeed in learning, I will fall out of the system. • 10 - I will be an outcast and a shlepper. I will disappointment to my parents, families and friends. • 11- if I become such a לא יוצלח then there is no point in trying – I will never get a normal shidduch and forget about a shteller. • 12 – I will be and feel worthless – • I’m poshut junk

13. Help!!! My life is in danger I better do something real quickly I can’t breathe Call Hatzalah – I’m having a heart attack

14. Lets go back to the top of the slide • What really happened? • You were having a little bit of trouble falling asleep… • And you already decided that you are junk and have no chance of ever being successful… • You created the fear! • Based on what???

15. Where did this person go wrong after all which line isn’t true? Cognitive distortions trigger feelings of anxiety, panic, depression, anger and/or guilt.

16. The next set of cognitive distortions Will be used for dealing with not only anxiety panic But also depression, guilt and anger. We will elaborate next week.

17. All or nothing thinking You look at things in absolute, black and white categories. Example – if I do not get it 100 percent clear it is worthless. Example: If you are not a complete success you are a total failure.

18. Overgeneralization • You view a single negative event as a never ending pattern of the defeat. • Example – if it is not working out well, it will surely be the worst. • Example - you may tell yourself “this always happens to me” or “I will never get it right”.

19. Mental filter • This is like a drop of ink that colors the entire bottle of water. • Example - You dwell on one negative detail, such as a and slight chance of something happening, or a single instance where this happened, and ignore all the reasons why not to worry. • Example - You dwell on one negative detail, such as an error you made, and ignore all the things you did right.

20. Discounting the positive You insist that your accomplishments or positive qualities do not count. (important in believing that you are able to live with anxiety)

21. Jumping to conclusions • You jump to conclusions that are not warranted by the facts • Example - You assume that people are currently judgmental and looking down on you. (especially in social anxiety) • You tell yourself that something terrible is about to happen, I just know I am going to blow it when I take my test next week.

22. Magnification and minimization • You blow things way out of proportion or shrink their importance. • The binocular trick. When you look through one end of the binoculars or your shortcomings scene as huge as Mount Everest. When you look through the other end, all your strengths and positive qualities seem to shrink down to nothing.

23. Emotional reasoning • You reason from how you feel, • Example – if I feel anxious so I must really be in danger • Example – I feel like a loser so I must really be one.

24. Should statements • You criticize yourself or other people with should’s and should not’s • Example - I should not feel so shy or nervous, what’s wrong with me. • Example - I should be able to fall asleep right away, I must have a real problem.

25. labeling • You generalize from a single flaw or shortcoming to your entire identity. • Example - Instead of saying I made a mistake you label yourself as a loser. • Example – instead of saying it’s hard you label it as impossible (This is an extreme form of overgeneralization)

26. Blame Instead of pinpointing the cause of a problem, you assign blame. • Self blame – you blame yourself for something you were not responsible for or beat yourself relentlessly whenever you making a mistake • Other – blame – you blame others and deny your own role in the problem

27. Take inventory • Which fears do you have? • Which style of thinking is fueling the anxiety in these worries?

28. Plan a strategy • Identify the irrational beliefs and the cognitive distortions. • Plan how to correct the thinking pattern which will in turn diminish the anxiety

29. Methods to show the person the flaw in his thinking • The survey method – what would most people say to your interpretation. • The double standard method - What would you advise most people on how to interpret your situation. • Socratic questioning - Focus on the logical proof of your belief and highlight the lack of evidence supporting them. • Cost-benefit analysis - Remind them that the alternative to therapy is a living גהינום.