by Dennis Greenberger,Ph.D.and Christine A. Padesky, Ph.D.
In today's managed-care environment, it is essential for clinicians to maximize limited therapy time. This hands-on workbook enables clients to reinforce skills learned in therapy, learn new material between sessions and continue the therapeutic learning process post-therapy.
In today's managed-care environment, it is essential for clinicians to maximize limited therapy time.
An ideal home assignment, Mind Over Mood is a step-by-step program that can be effectively used to address a wide variety of psychological problems, including depression, panic attacks, anxiety, anger, guilt, shame, low self-esteem, eating disorders, substance abuse, and relationship problems. This hands-on workbook enables clients to reinforce skills learned in therapy, learn new material between sessions, and continue the therapeutic learning process post-therapy. Special features include worksheets, mood questionnaires, and an "open-flat" binding to facilitate reading and writing ease.
Also available in Spanish
See companion book Clinician's Guide to Mind Over Mood
Although emotions generally enrich our life, too much emotion can be disruptive. While all the chapters of this book teach general skills for managing moods, the final three chapters provide specialized information that can help you reduce the frequency and severity of five moods that create distress for people: depression, anxiety, anger, guilt, and shame. You can read only those chapters that describe the moods you would like to understand and change.
In Mind Over Mood, you learn about depression through the lives of Ben, Vic, and Marissa. Ben's depression was rather recent and followed important life changes. Vic, in addition to alcoholism, had been struggling for most of his life with low self-esteem and a sense of worthlessness. Marissa's depression symptoms included suicide attempts, low self-esteem and feelings of guilt. Depression includes not only sad mood but also numerous cognitive, behavioral, physical and emotional symptoms are severe, chronic, or occur repeatedly, they may interfere with our personal relationships or our work.
EXERCISE: Identifying and Assessing Symptoms of Depression
To help identify the symptoms of depression you are experiencing, rate the symptoms listed on the Mind Over Mood Depression Inventory on Worksheet 10.1. Fill out this inventory periodically as you use this book to assess how your depression is changing and which interventions are most worthwhile.
- Score the inventory by adding up the numbers you circled for all the items. For example, if you circled 3 for each item, your score would be 57 (3X19 items). If you couldn't decide between two numbers for an item and circled both, add only the higher number. Compare your scores once or twice each week to see if your symptoms are decreasing and which symptoms are improving and which are not.
- To chart change, record your Mind Over Mood Depression Inventory scores on Worksheet 10.2 on page 156. Mark each column with the date you completed the Depression Inventory. Then put an X in the column across from you score.
You may find that your scores fluctuate from week to week or do not improve each and every time you fill out the inventory. Some weeks your score may be higher (more depressed) than the week before. This is not unusual nor is it a bad sign; in fact, it reflects a pattern of recovery. Decreasing scores over time are a sign that the changes you are making are contributing to your improvement.
You may have noted that the symptoms on the Mind Over Mood Depression Inventory are cognitive, behavioral, emotional, and physical changes, just as in the model for understanding problems described in Chapter 1. Cognitive symptoms of depression include self-criticism, hopelessness, suicidal thoughts, concentration difficulties, and overall negativity. Behavior changes associated with depression include withdrawl from other people, not doing as many activities that are enjoyable or pleasurable, and having difficulty 'getting started' with activities. Physical symptoms associated with depression include insomnia, sleeping more or less than usual, being tired, eating less or more, and weight changes. The emotional symptoms that accompany depression include feelings of sadness, irritability, anger, guilt, and nervousness.
Does it surprise you to learn that some of these symptoms are characteristic of depression? Some people believe that problems with sleep, appetite, motivation, or anger are separate from and in addition to depression. But for most people, these symptoms are associated with depression and successful treatment of depression results in improvement in all the associated symptoms.
COGNITIVE ASPECTS OF DEPRESSION
Aaron T. Beck has pioneered our modern understanding of depression. In the 1960s, Beck demonstrated that depression was characterized by thought patterns that actually maintained the depressed mood. For example, Beck noted that when we are depressed we have negative thoughts about self (self-criticism), about the world (general negativity), and about our future (hopelessness). The following sections describe these aspects of depressed thinking in detail.
Negative Thoughts About Self
Before Marissa began cognitive therapy, she was extremely self-critical. For example, she thought, "I must be worthless for all these awful things to have happened to me," "I'm no good as a mother or as a person," "If I were a good person, I wouldn't have been sexually abuse," "On some level, I probably deserved to be beaten by my husbands." The core belief underlying each of these thoughts is, "I'm worthless" or "I'm no good."
Almost everyone who is depressed thinks these types of self-critical thoughts. The thoughts are damaging because they contribute to low self-esteem, low self-confidence, and relationship problems, and they can interfere with our willingness to do things to help us feel better.
To demonstrate how self-criticism plays a role in your life, rememeber a time when your self-esteem or self-confidence was particularly low. It may have been a time when you felt worthless and unlovable. Picture in your mind the moment you were feeling most depressed and remember or speculate what you may have been thinking. Did you have any negative thoughts about yourself? If so, write them here:
These thoughts illustrate the self-critical thoughts associated with depression.
Negative Thoughts About the World
Thinking about your current experiences in a negative way is another characteristic of depressive thinking. We often do not take events at face value: We interpret or misinterpret events that occur around us. An example of this is 'reading between the lines' when a friend, relative, or coworker is talking. When we are depressed we often perceive others as negative, mean, or critical.
Negative thinking about the world is a style of thinking in which we notice and remember negative aspects of our experiences more vividly than postive or neutral events. For example, when we are depressed we tend to look at and remember the articles in the newspaper that report disasters and not remember the articles that report positive events. Focusing on the two out of ten chores that did not get done on a Saturday would be another example of negative thinking about the world.
Negative Thoughts About the Future
During his first therapy session, Ben's hopelessness was revealed in his statement, "What's the use? The rest of my life will be filled with illness and death." After his wife's successful battle with cancer and the death of his good friend Louie, Ben had come to believe that his own life and the lives of people he was close to would be one tragedy after another, culminating eventually in his own death. He was unable to envision anything other than a bleak future.
When we are depressed we imagine that the future will be completely negative. This prediction or anticipation that events will turn out negatively is hopelessness. Examples of this type of thinking include "I'll blow it," "Nobody there will like me," "I won't be good at it." A negative attitude toward the future may also manifest itself in thoughts like, "I'll never get out of this depression" or "What's the use in trying? I'll never get any better." We may anticipate that a conversation will go poorly, a new relationship won't work out, a problem can't be solved, or that there is no way out of the depression. In its most extreme form, hopelessness can contribute to thoughts of suicide.
To demonstrate how negative thinking about the future functions in your life, identify an activity you sometimes enjoy but do not do when you are depressed because you predict it will not turn out well. Write in the space at the top of the next page the activity you avoid and your negative prediction of how it will turn out.
243 pages; 8 1/2 X 11;soft bound
- Understanding Your Problems
- It's the Thought That Counts
- Identifying and Rating Moods
- Situations, Moods, and Thoughts
- Automatic Thoughts
- Where's the Evidence?
- Alternative or Balanced Thinking
- Experiments and Action Plans
- Assumptions and Core Beliefs
- Understanding Depression
- Understanding Anxiety
- Understanding Anger, Guilt, and Shame
- Letter to Professionals
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