Just as you might apply sunscreen to your skin on those sunnier days, your overall wellbeing could also do with some love and attention in the summer months.
I find this maintenance model, created by Moorey (2010), a really useful tool to explore elements that might be maintaining struggles with anxiety and depression.
Each section can be explored in any order, and you may find that one or two sections are fine and don’t need any changes. Taking a curious and non-judgemental approach, you can work through each section creating an opportunity to find that balance for your self-care essentials.
Here is my interpretation of the model with a description of each section, and what can help make a difference.
What to do with automatic negative thoughts: It’s suggested that we can have anywhere between 6000 – 7000 automatic thoughts in a day. This is our body and minds way of analysing, planning and assessing our environment to keep us safe from potential threats. Examples of these can ranges from Planning thoughts “What am I having for dinner later”; Worry thoughts “What if I can’t do this and I make a mistake?”; self-reassurance or critical thoughts “I can do this / I’m rubbish at doing this”; or just some random thoughts that don’t make sense and are gone before you fully acknowledge them. They can come as an inner voice or sound, an image, a memory, or a sense based on intuition and curiosity.
We are amazing aren’t we!
The problem with some automatic thoughts is that some do not help the situation and stick around longer than they are needed. This happens when we have perceived a threat that actually is not imminent danger but feels like it is happening right here and now. They grab our attention and then often follow up with another bigger, louder, scarier thought. Before you know it, you have imagined the situation to be much worse than it actually might be, talked yourself out of doing something, and feel rubbish about yourself. You’d be amazed at how common this is, it’s just not common to share all of our thousands of thoughts with everyone.
The first step to making some changes is to write these thoughts down or make voice notes. The more you acknowledge and become aware of them, the easier it will be to begin to introduce balance. Remember, we can’t stop these thoughts, they are automatic. We can however remind ourselves that they are Just Thoughts. Thoughts can’t harm you. Once you have noticed any difficult thoughts, you can then begin to understand what kinds of thoughts they are, and if there is an opportunity to introduce some balance. This would either be challenging them or refocusing your attention using grounding techniques if you find your thoughts distracting. Follow me on Instagram for some suggested grounding techniques.
Managing rumination and self-attacking: These two thinking styles are not the only unhelpful thinking styles we have, but they are probably the biggest and most influential for maintaining depression and anxiety. Rumination is one of those automatic thoughts that can spiral. It’s when our mind travels in to the past and examines certain situations over and over again. It might be that you’re trying to make sense of a situation, wondering if you could have done anything differently, or simply worrying that you might have done or said the wrong thing. It can be helpful to review past situations, this gives us the opportunity to learn from our mistakes and grow. However, it is unhelpful if you find yourself repeatedly going over things, getting distracted by it and not applying new learning to move forward.
If you are struggling with anxiety and or depression, you are also more likely put yourself under the microscope of life, and home in on the negatives. If you were to write down some of the things your inner self-critic says to you, I can imagine it’s not something you would say to a friend in the same situation. If we say these negative things to ourselves, we are more likely to focus on any evidence to support that thought and dismiss anything positive.
The first step to making some changes is again raising your awareness of this thinking style. Write these thoughts down or make voice notes. The more you acknowledge and become aware of them, the easier it will be to begin to introduce balance. You can then replace your response with a more compassionate one, similar to advice or support you would give to a friend.
Moods and emotions: feelings are strong and can be overwhelming at times. They can often influence our behaviour and be influenced by other factors. For example, responding in anger and then regretting your actions, listening to sad music and feeling low. Our emotions are like an internal radio, communicating with us to help figure out how a situation makes us feel. It can impact on our relationships, choices we make and our behaviour.
First steps to making a change is to increase your awareness of what you are feeling and naming that emotion. This can give you greater control over how you would like to respond, rather than your emotions influencing your behaviour. Using a mood rating throughout the day can help recognise mood shifts. It will also enable you to recognise what activities lift your mood. An example of a mood rating could be using a sliding scale of 0-10 where 0 is fine and 10 is anxious or feeling low. Check out my free resources page for an emotion’s thermometer.
Withdrawal and avoidance: Our automatic thoughts and emotions are all a means of communication. Our body and mind are working on instinct to keep us safe. If we are in the habit of imagining and fearing the worst, it communicates danger, and our instinct is to withdraw and avoid. If you are withdrawing and avoiding, then your alarm system for danger is working perfectly. However, what if your withdrawal and avoidance meant that you would be missing out on something that might actually be fun? The first move to overcoming withdrawal and avoidance is to activate one step at a time. Notice what you are avoiding, why you are avoiding it, where would you like to get to and what small steps can you take to get there?
Unhelpful behaviours: Similarly, to the withdrawal and avoidance, there may be other behaviours you do in order to help you feel safe but are actually unhelpful in the long term. Examples of these might be drinking excessive alcohol before a social event to feel confident, checking behaviours such as internet surfing and other repetitive actions, avoiding eye contact, putting off starting or completing tasks, fidgeting, carrying or holding objects or sticking very close by to certain people that make you feel safe.
Raising your awareness of these in a curious and non-judgemental approach is a good first step. This allows you to recognise these behaviours, explore why they are there, and then begin to experiment with alternatives.
Motivation and physical symptoms: Just as our automatic thoughts and emotions are a means of communication, our physical symptoms also let us know what is going on. When we respond on natural instinct to a perceived threat, our body prepares to get ready to fight or run away. This can be tension in our muscles, feeling shaky or lightheaded, shallow breathing, butterflies in our stomach, tingling or temperature changes in our hands and feet, racing heart, rush of adrenalin, or a dry mouth. Our body might also naturally enter a Freeze response which would help us hide more effectively from the perceived danger.
If you notice any of these physical symptoms, again in a curious and non-judgemental way, begin to explore what you might be responding to. Using meditations, breathing techniques and gentle stretching you can begin to calm down that physical response and communicate back to your body and mind that there is no imminent danger. Exercising is one way of improving your well-being. Getting active and outdoors can help raise your mood by releasing endorphins, otherwise known as happy hormones. What three small actions could you make to get moving again?
Working with a therapist can help you increase your awareness of unhelpful thoughts and behaviours, and how they are impacting negatively on your life. This process then allows you to challenge those thoughts and behaviours so that you can create more balanced and positive changes in your self-care.
CBT itself is short-term, working towards goals for positive change. The techniques you learn will support you going forward in reducing the impact anxiety and feelings of overwhelm has on your life.
If you would like to talk more about how CBT can help you, please contact me at amy_langshaw@outlook.com or use the contact form at the bottom of my home page.
Moorey, S. (2010). The six cycles maintenance model: Growing a “vicious flower” for depression. Behavioural and cognitive psychotherapy
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