As we approach Fourth of July, I’ve been thinking about American thinking. Americans regard happiness as powerful. We have since 1776, when the Declaration of Independence was written and included the beautiful words, “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”
Yet, how does one pursue happiness? I use something called cognitive behavioral therapy. This is a general term for a classification of psychotherapy that emphasizes the important role of thinking in how we feel and what we do. I use it on myself all day, every day. I also use cognitive behavioral therapy, together with pharmacotherapy, in my work with people who are experiencing acute mental illness.
Psychiatrists, psychologists, clinical social workers and mental health workers of all disciplines work in an era when evidence of effectiveness must be presented (as well it should be), and cognitive behavioral therapy is the best documented treatment for major depressive disorder and related conditions, anxiety disorders, trauma, psychoses and for most other brain disorders. Cognitive behavioral therapy methods can be very helpful in working with anyone with a sense of hopelessness and suicidal thinking. It has been shown to be effective for insomnia, in treatment of substance abuse, for helping with problems of habits or lifestyle, such as sticking to diets or breaking patterns of procrastination. It also is effective for children and adolescents, with particular adaptations made in terms of pacing the content to a level appropriate for the child.
I use cognitive behavioral therapy because it works. I also use cognitive behavioral therapy because it is collaborative. The cognitive behavioral therapy clinician creates a collaborative therapeutic relationship in which the patient or client takes an active role in learning about their illness or problem, making decisions and implementing a treatment plan. I am not the expert on patients or clients. They, with their families and friends, are the experts on themselves. One of the important goals is to help patients and clients learn enough about the very practical cognitive behavioral therapy methods so that they no longer need to rely on the therapist for solutions to their problems. They can reach a point where they spot cognitive distortions or maladaptive behaviors and, with skills learned from cognitive behavioral therapy, reverse these patterns.
The first principle of cognitive behavioral therapy is that our moods and feelings are caused by our “cognitions.” Cognitions are the way we think about things at any moment, including this moment. What we are thinking at this moment creates our feelings at this moment. Our feelings result from the messages we give ourselves. The moment we have a certain thought and believe it, we will experience an immediate emotional response.
Yet, research has documented that the negative thoughts that cause our emotional turmoil contain gross distortions; they are irrational and are not based on accurate perceptions of reality. Anxiety and depression are the most common mental health problems and they create tremendous suffering. The thoughts that create these feelings, though, are always distorted and illogical, even though they feel absolutely valid. The way we know we believe a negative thought is that we feel stress. A thought is harmless unless we believe it. When we use cognitive behavioral therapy, we look for whether there is any evidence that our negative thoughts are valid. The discovery that negative thoughts aren’t valid can be absolutely exhilarating and freeing because we develop a radically new understanding of ourselves and the world.
For example, I used to believe I could change the world. So I was often sad, because the world didn’t seem to be changing in the way I thought it should be changing. I was focused on all that was “wrong” with society. Then I found cognitive behavioral therapy. I learned that I could change myself. And as I did, I became happier and more peaceful. And as a result, I actually may be helpful to the world in changing it for the better. I began to focus on what was “good” about society. I became a better citizen.
The theory behind this is simple, it is accessible to people of all backgrounds, and it requires nothing more than a willingness to open the mind. In fact, studies have even shown that cognitive behavioral therapy may actually change the chemistry and architecture of our brains.
We have the power to question our stories, and thereby write a new one. In other words, we can rewrite our present no matter what our past contains. This is very powerful. And very American. We know we can pursue happiness. Happy Fourth of July.
Robin Barstow is a clinical social worker for Maine Behavioral Healthcare, primarily at Spring Harbor Hospital in Westbrook.