How to Treat and Manage Depression With CBT

Learn how to treat and manage depression with these strategies from cognitive behavioral therapy (CBT) and mindfulness based cognitive therapy (MBCT), two of the most effective treatments for depression. We’ll look at how changes in behavior via behavioral activation can help ease depression, how changing our thoughts and how we relate to our thought with cognitive restructuring and mindfulness can help us start feeling less depressed, and how we can manage our emotions when we’re struggling with depression.

6 Tips to Treat and Manage Depression

 
 

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Cognitive Fusion and Defusion in Acceptance & Commitment Therapy

 

In a previous post we looked at some ways to practice letting go of thoughts, but it can often be difficult to let of thoughts because they have such a powerful pull, especially when the thoughts are related to a strong emotion. In my post, What is Acceptance and Commitment Therapy?, we learned why acceptance is so important in ACT. Cognitive defusion is a way of accepting our thoughts, allowing them to pass into and out of our minds, without getting stuck in our heads.

Steven Hayes, who developed Acceptance and Commitment Therapy (ACT), coined the term “cognitive fusion” to describe times when we are so tightly stuck to our thoughts, we become “fused” to them. When we’re experiencing cognitive fusion, we can’t separate ourselves from our thoughts. Our thoughts become our reality. We feel removed from the world outside of our thoughts, removed from our senses, from what we’re doing, and even from the people around us.

The opposite of “cognitive fusion” is “cognitive defusion.” Cognitive defusion involves taking a step back from what’s going on in our minds, and detaching a little from our thoughts. In this state of defusion, we can observe our thoughts and other internal processes without getting lost in them, stuck in them or fused with them. We can simply notice our thoughts, watch them, accept them and let them go if we choose to.

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Letting Go of Thoughts Mindfully

racing thoughtsIt’s easy to get swept away by our thoughts, especially in the face of strong emotions. We get stuck ruminating and dwelling about the past, filled with guilt or regret. Or our minds start racing and we can’t stop worrying about the future and imagining all the things that could go wrong. Or we replay conversations over and over again in our heads, trying to make sense of them or figure out what we could have said differently.

When our minds get going like this, not only is it exhausting; these patterns of thinking tend to make us feel bad, intensifying the emotions we’re already feeling and generating additional negative emotions as well. Because this experience is so unpleasant, it’s natural to want to these thoughts to stop, and to be able to prevent yourself from even having them in the first place. We often wind up trying to make these thoughts go away, and shut them out completely and make sure they don’t come back. But just like we can’t control our emotions or suppress our emotions, neither can we control or suppress our thoughts.

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Mindfulness of the Breath Meditation

woman meditating

Free Clip Art (CC BY-SA 4.0) from Wikimedia Commons

In previous posts we practiced Following Our Breathing By Counting Breaths and Following Your Breathing By Measuring Breaths. Now we’re going to learn a brief Mindfulness of the Breath Meditation.

You can do this meditation either sitting cross-legged on a cushion the floor, or on a firm chair with a straight back and preferably no armrests. You want to be in a comfortable but alert posture, with your back straight but not stiff, you shoulders relaxed, on your hands resting in your lap or on your knees.

When you’re ready, start the video below to play the guided mindfulness of the breath meditation.

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