Psychology Addict # 25 | Depression through the lens of CBT & the case study of Mr. B.

in #psychology6 years ago (edited)

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Cognitive Behavioural Therapy

I have stated before that one of the purposes of my blog is to raise awareness about Psychology on this platform, and consequently debunk misconceptions about mental health. Of course, for this, one of the things I would like my readers to accept is that psychology is not a field entrenched within the boundaries of psychoanalysis, and that talking psychology goes way beyond than talking Sigmund Freud and Carl Jung.

The reason why I have pointed this out in my introduction is because in this post I will discuss Cognitive Behavioural Therapy - CBT. A therapeutic approach rooted in the principles of conditioning (learning) theories, which were first proposed by the now known ͚radical behaviourists͛– Pavlov, Wolpe, Skinner – the very figures who disapproved of the theoretical and subjective methods of psychoanalyses and worked towards turning psychology into a study that is more observable, objective and measurable.

This is precisely what Cognitive Behavioural Therapy is, and its rapid development is largely to do with its empirical grounding. CBT has demonstrated to be very effective in the treatment of conditions such as OCD, panic disorders and depression. So, this is when I should introduce you to Mr. B, a 50-year-old real client who suffered from comorbid major depression and OCD.

Emotions according to CBT


But, before we further explore Mr. B͛s case, let us first see how cognitive behavioural therapy makes sense of emotions, specifically sadness.

In CBT difficult feelings such as sadness (and anxiety) are seen not only as normal, but also as healthy reactions to the environment and life in general. However, when someone experiences such feelings in their most extreme, they can develop avoidant behaviour (for example, stop engaging in daily activities), which will inevitably distance them from family and friends; in turn, causing feeling of detachment that in most cases leads to suicidal thoughts.

This is precisely what happened to Mr. B, who had been divorced for nearly a decade, with no subsequent romantic relationships, jobless for the past six months, and only saw his teenage children every other weekend. Mr. B lived on his own making ends meet with a disability pension and had been contemplating suicide.

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A Pattern of Negative Thinking


Although sometimes depression emerges without any clear causes, most often it arises from life situations that involve some kind of loss. When sadness becomes prolonged and causes psychological pain, it triggers a pattern of thinking in which the person gets stuck. It goes pretty much like this:

Negative thoughts > triggering low mood > prompting more negative thoughts > lowering the mood further, and so back to the beginning.


This is a notion that reminds me of a study I came across not long ago (it was not CBT related) which demonstrates that negative emotions also trigger bad memories. Indeed, in some clinical environments it has been noticed that clients afflicted by major depression have great difficulties in recalling good memories. But, the negative thoughts referred to in the pattern mentioned above are not memory related, they have more to do with what Tim Beck defined, in 1976, as the negative cognitive triad - negativity towards oneself, one͛s experience as well as one͛s future. Mr. B experienced all this through ideas that reflected beliefs similar to: "It´s is all my fault", "it will always be this way."


In Mr. B´s case this cycle is particularly serious because it increases his level of anxiety and aggravates his obsessive compulsive behavior. Prior to treatment Mr. B carried out several rituals during the day, they included checking whether doors were locked, and taps and light switches were off. In more difficult days Mr. B would check if the light switches were off even when the rooms were in absolute darkness. This was the way he found to cope with the terrifying, intrusive thoughts of having his house broken into.

Don͛t forget I mentioned earlier that his depression coexisted with OCD.

The Case Study

In neuropsychology a case study is the in-depth study of a single individual using a range of different methods.

Now that you have become acquainted with Mr. B and with how CBT interprets depression, I can present the aim of the case study:

To evaluate how a treatment that combined CBT (particularly behavioural activation) and psychopharmacotherapy improves the psychological health and alleviates symptoms of comorbid OCD and major depression.


Behavioural Activation is a specific method/treatment within cognitive behavioural therapy to treat depression. Here the therapist supports the client to acknowledge, once again, those activities in life which he used to see as enjoyable, but that he has now abandoned (avoidant behaviour). The ultimate goal of this is to guide the client and help him to re-engage in these activities; and consequently, have an increased level of positive reinforcement in his day-to-day life.

Why do it this way? The logic behind this is that by eliminating symptoms of depression (and anxiety) the client will become better prepared to, later on, address deeper psychological issues. Also this also equips the client to see things differently, and therefore attach a more positive meaning to life events and experiences. This is in fact, the fundamental concept in cognitive behavioural theory: it is not so much the situation that prompts emotional reactions; but rather the meaning that the person concerned associate to it. The meaning will then be a result of the interplay between the individual͛s personal history, overall life context and current mood state.


At the end of the 21-month-treatment, Mr. B, who had been completely avoidant, had finished a technical course, was about to start a six-month computer training, and had two potential job positions awaiting him.

This considerable change in Mr. B͛s behaviour and mindset was a result of a highly structured therapeutic program based on a shared understanding and collaborative work, where he was the authority in his own distress and the therapist through his specialized knowledge of depression offered alternative ways for Mr. B to see and experience the world through challenging his negative beliefs.

A range of cognitive techniques can be used in this specific treatment strategy. In this very case, Mr. B was asked to keep a diary where he recorded his thoughts and feelings, he undertook psychometric tests, and took several different psychopharmacological drugs - one at a time throughout the twenty one months (clomipramine, duloxetine, buspirone and lithium). The drugs were prescribed by a psychiatrist who worked in conjunction with the therapist.

The observable and measurable aspects of Mr. B’s treatment

In many ways Mr. B͛s treatment progress and outcome are observable. In his pre-treatment assessment Mr. B was identified as a fully avoidant individual, presenting poor self-care, self-deprecating thoughts, suicidal ideation and compulsive behaviour. After a period of twenty one months he was functional in household activities, self-care and social events. Mr. B himself reported "...my mind is sharper and in more control of my thoughts". Subsequently to stopping taking lithium he also claimed to be feeling more energetic in his daily activities.

As for the measurable aspects, Mr. B demonstrated a decrease in compulsive and obsessive behaviour, depression, anxiety and stress. With ratings of obsessive compulsion going from 31 to 15, depression ratings going from 47 to asymptomatic levels as well as anxiety, where ratings were seen to go from 40 to asymptomatic levels too – These were all measures obtained from the psychometric tests mentioned earlier. Finally, Mr. B presented a gradual decline in the frequency of checking behaviours throughout the 21 months, which at the beginning was at a mean of 101 per day and steadily went down to a mean of 19 per day.

What does this case study tells us?

  • That a treatment combining behavioural activation and psychopharmacotherapy is efficient in alleviating symptoms and improving the psychological health of the client.
  • That a long-term treatment combining behavioural activation and psychopharmacotherapy effectively treats comorbid OCD and depression.
  • It indicates that cases of comorbid disorders that include severe depression may see positive outcomes when treated with behavioural activation.

But it is also important to notice that not all individuals will necessarily benefit from cognitive behavioural therapy. Not rarely, it is seen that one kind of approach will suit a person better than another. Mr. B himself previously attempted to treat his comorbid conditions with psychoanalysis; but experienced no significant improvement in his psychological health and overall well-being. It is also important to note that his was a prolonged treatment, something which the author of the paper highlights as one of the contributing factors for the successful outcome.

Criticism

Not surprisingly the main criticism towards the cognitive behavioural approach comes from psychoanalysts, who claim the elimination of symptoms is not the same as targeting the real cause of the difficult emotional state. Psychoanalysts argue that what this most likely will do is to actually make the ´suppressed´ symptom reappear in the form of ´neurosis´.

There has been no evidence for this, however. Plus, the effectiveness of cognitive behavioural therapy in the treatment of conditions such as social phobias, PTSD, OCD and a few others is nowadays undisputable due to the evidence available.

Reflection

Now that you have a better understanding about cognitive therapy, I would like to ask you to reflect on a few questions:

Do you agree with the behaviourist notion that proposes that it is not the situation per se that causes emotional responses; but rather the meaning attached to it?

Whenever you feel sad or anxious do you also resort to strategies that alleviate the symptoms of your difficult feelings?

[Original Content by Abigail Dantes 2018]


Reference list:

Arco, L. (2015), A case study in treating chronic comorbid obsessive-compulsive disorder and depression with behavioural activation and pharmacotherapy. Psychotherapy, vol. 52, No. 2, pp.278-286

Beck, J. (1995). Cognitive Therapy: Basic and beyond. New York: Guilford Press.

Image source 1, 2, 3, 4.

Dear Reader,
Thank you so much for taking the time to read and engage with my work! I wish you all a great weekend ahead 😊
Best.
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Depression is a psychological disease and his medicine is psychologically with the participation of social emotions in ways that sound according to the '' values ''.
So I say that the prevention of this spiritual disease ie embrace religion is right for him.
"Smart Atheist commits suicide" as wisdom.

The impairment of chemical balance in your brain is important in the formation of this disease. The synapses between the neurons of the serotonin and noradrenaline in the brain are reduced in the given space. This decrease leads to the appearance of depressive symptoms. This decrease, which is sometimes spontaneous, sometimes occurs after some compelling life events. Past traumas, losses, sadness and difficulties, still ongoing problems, emerging coercive life events, low educational level, poverty can also cause depression.. @slimanepro @abigail-dantes

Another great read. So, I have gone through TWO rounds of CPT (cognitive processing therapy). I'm not sure if it's the same, but it sounds like it is. So, what follows is simply my own experience with the whole process. My problem with things like CPT and modern mental health in general, is the approach in which it's dealt with. Sterile rooms, distracted therapists, factory-production style psychiatry. My CPT sessions were each twelve weeks in duration. One in a group, the other as a one-on-one approach. I understood the goal of the treatment, but for me, as you say in your post, it's a therapy that won't necessarily work for everyone. It wasn't for lack of being involved or being proactive; I've been incredibly proactive about my mental health. (Starting therapy almost as soon as I got back from Afghanistan). The approach of sitting down, writing, talking, and doing it all over again just didn't seem to take. You ask whether or not it's situation or meaning, and as a combat veteran, I think it's both. Sometimes it's hard to separate the situation from the emotion. In combat, you are constantly running on such base emotion and primal instinct, that those two become inseparable. When you train for combat, you're hammering back all those emotions that would come flooding forward, the "fight-or-flight" responses, and so you are actively over-riding those pathways. As weird as it sounds, it's easier to train your mind into that "always-ready" state than it is to bring it out of it. And so now, as a combat veteran, when you approach situations like large crowds, that situation triggers an emotion, a ready-state, based on actual experience. We had a saying, basically, the Marine Corps did a great job of training us for war, but a horrible job of training us to come back, and re-integrate into society. Of course, not every Veteran that experiences combat has PTSD, but many, if not most, will undoubtedly have some residual effects left-over from the experience of combat. Anxiety. Depression.
Also, in my experience, I've learned that PTSD in combat veterans seems to have a common theme; most having already dealt with a previous traumatic experience, (being molested, raped, abuse, alcohol and chaos in the home; which is where I'd fall in, the alcohol and chaos and fighting.)
Now, when I start having those feeling, I take to my writing, or I head out into the woods for fresh air and nature. It's tricky though because my depression is heavy, and comes on like a tide in the ocean. All of the sudden, I'm sitting on the bench of my own life-game, even during the beautiful moments. If it's real bad, I turn to Psilocybin mushrooms, as those have had the most profound impact on my entire outlook on life, my mental health. So, all is not doom and gloom. Healing can, and is, occurring. Thanks for casting light on these kinds of topics! I enjoy these articles!

Just one question.. What is CPT?

Here is the Wikipedia definition of CPT:
Cognitive processing therapy (CPT) is a manualized therapy used by clinicians to help people recover from posttraumatic stress disorder (PTSD) and related conditions.[1] It includes elements of cognitive behavioral therapy (CBT) treatments. A typical 12-session run of CPT has proven effective in treating PTSD across a variety of populations, including combat veterans,[2][3][4] sexual assault victims,[5][6][7] and refugees.[8] CPT can be provided in individual and group treatment formats.
Basically, you sit down with a therapist, they give you worksheets on feelings and you're supposed to go home, write down a significant situation/feeling that arises, and why it might make you feel this way. You then write how you could respond to it differently. Then, you discuss it with said therapist, during the allotted time slot, (since they have fifty other vets to see that day), in hopes of re-training the brain to approach feeling/situation/emotion differently. I guess for me, it was too standardized, too formulaic. That's not how my mind works, ever worked. We also did an abbreviated form of this during my stay at Laurel Ridge, a psychiatric hospital with a military-specific wing in San Antonio. It's interesting that this is what the VA uses, yet, even when Veterans go through these "standardized" treatments and sensory-dulling medications, they still end up killing themselves or descending deeper into depression, isolation. I've had to talk more vets than I care to think about from taking that plunge down the dark abyss of suicide. Already lost one good friend to it. So, something isn't working. There's a break down in the system at the human level. Of course, this is just my own opinion.

Thank you :)

@therightsideofup, again, THANK you so much for taking the time to teach us so much about a reality that is so far-fetched to, I dare to say, all of us here taking part in this debate. Throughout your post I was first, particularly touched by this:

Also, in my experience, I've learned that PTSD in combat veterans seems to have a common theme; most having already dealt with a previous traumatic experience, (being molested, raped, abuse, alcohol and chaos in the home; which is where I'd fall in, the alcohol and chaos and fighting.)but a horrible job of training us to come back, and re-integrate into society

Now, I want to look for literature that addresses this reality! Books, papers... etc...

I have com across this information before.

Also, in my experience, I've learned that PTSD in combat veterans seems to have a common theme; most having already dealt with a previous traumatic experience, (being molested, raped, abuse, alcohol and chaos in the home; which is where I'd fall in, the alcohol and chaos and fighting.)

This is also something worth looking into. Considering that so many have these common aspects I would be particularly interesting in learning how their expectations from the experience they are going to encounter are similar.

I read your post about your experience Psilocybin mushrooms, I found it very enlightening.

Thanks for your always kind, encouraging words about my work!
All the best to you :)

Any time! You put out high-quality, thought-provoking material on a subject that interests me. It was interesting, to realize that other Veterans dealing with PTSD had some type of significant trauma, buried deep in their past. It took another traumatic event, such as combat or the clean-up crew that had to literally pick up body parts of their friends after an IED blast. The band-aid of Time was ripped off, reopening old wounds, and adding a few more to it. Of course, the other aspect is support, and sadly, many had support systems that were failing, or just didn't believe in PTSD to begin with. The Veteran community even cannibalizes itself on this topic.

Thank you, Abigail Dante, for another wonderful article in which I see myself as in a mirror. :D
I want to answer your last question, but before I tell you what you think just to tell you that I suffer from depression for a long time. First was the social phobia and then come the depression. :D There are periods in which I don't go out for months, but when I do it, I crash mentally and have panic attacks like friends :D I have tried to heal, I've been to psychoanalysts, psychiatrists, but there was no effect. After living with these grim feelings and inner anguish, almost half of my life, I turn to the past and ask myself: why should I avoid them? If I don't have this problems, I would not be the person I am now. I was not going to make the things I do. I would not create music, I would not write stories and plays, I would not be so interested in literature and all kinds of things related to the spiritual. I was going to be a superficial and ordinary man with ordinary work and ordinary life. Depression has created a depth in me, which is my source of inspiration, and to be tortured by this suffering I am giving birth to something of value. That's why I want to dive into the deep with them, not to escape the pain, that is what makes me a meaningful person. I have read an interview with the absurd playwright Eugene Ionesco, who you know, writing a lot of irrational and fantasy stuff. According to him, the psychologists will find some neuroses in him that need to be treated, but that neurosis make Ionesco great. Yes, certain people need to be treated, those who can't take advantage of their depression and crash them completely, but there are cases when the depression is the cure itself. Thank you once again for this article, and I am glad that you will not mention Jung and Freud so much and expanding my psyche in psychology. :D

All the best. :)

Dearest @godflesh, it is always a pleasure reading your writings! Your comment fascinates me in so many levels. But this particular part just made me smile a smile of admiration and respect for you:

If I don't have this problems, I would not be the person I am now. I was not going to make the things I do. I would not create music, I would not write stories and plays, I would not be so interested in literature and all kinds of things related to the spiritual.

It reminded me of an old professor of mine, who used to criticize both BTC and Psychoanalyses. He would raise these very point. He had depression, but very much like yourself, at one point he began to embrace it as something that actually made part of who he was: an insightful, educated man (just like you).

Thank you for writing your personal experience here. I am sure that it's going to open A LOT of closed minds and also inspire those of us who struggle to accept the inevitable, unavoidable difficult feelings that this life present us with!

All the best to you always! :)

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Although I am not a supporter of the CBT I cannot deny it's results. It works.
But the question is not about whether it does or not. Let's end the debate which is best and universal in all cases analysis or CBT. Things are not that simple. If your method works for your client - good use it. If it doesn't, don't force it.

"The situation per se that causes emotional responses - rather the meaning attached to it" - I thinks it's true and in some way it's what psychoanalysis claims it does as well. The emotion is a manifestation of the problem.

Whenever I feel sad or anxious I don't treat my symptoms but self-reflect and try to understand them in order to reach their origin. This requires a lot of personal mental resource and thank god we have therapy as tool to help us :)

Once again, nothing but quality content, @abigail-dantes :)

This requires a lot of personal mental resource and thank god we have therapy as tool to help us :)

Oh yes!

I appreciate your constant support and input very much @dysfunctional! :D
All the best to you.

Thank you for bringing up another topic of your profession and including your readers. I like it! :)

Do you agree with the behaviourist notion that proposes that it is not the situation per se that causes emotional responses; but rather the meaning attached to it?

I agree partly. I guess it is always a mix of many factors, which can be summarized by "outer conditions/circumstances" and "inner perception/evaluation." For this I use the experiment with rats, I unfortunately do not have a source (but will try to look it up).

In the experiment with the animals, the addictive effect of cocaine was tested and whether the subsequent generation of the rats involved would also develop an addiction. So the rats were given cocaine as an addition to the food. All rats - including the rat children - developed an addiction. Until someone came up with the idea to change the environment and create a kind of "rat paradise" instead of the dreary laboratory environment with what rats are pleasant. The result was that all rats left the cocaine on the side and the rat children showed no interest in it. The rats were doing so well in this paradisiacal environment that they despised the drug.

Which made me think that people behave in a similar way. If their environment is barren and dismal, if they are not distracted and occupied by the things around them, there may be no impetus to develop positive motives or to react impulsively to the environment, for example, isolation is not necessarily perceived as such only by the subjective assessment of people, but is promoted by the fact that isolation actually prevails. For example, in large cities and the fact that we are less dependent on social interaction due to the external supply. Coming to a lonely apartment after work.

However, I don't dare to judge the weighting. In any case, I am convinced that inner convictions and beliefs have a very great effect on how unhappy or happy someone feels.


Whenever you feel sad or anxious do you also resort to strategies that alleviate the symptoms of your difficult feelings?

I have learned that. In the past, I tended to intensify the negative feelings by thinking and worrying (more of the same). Today it helps me to think that the difficult situation will surely pass. How it all goes away. This helps me to turn my attention to something else and to leave the brooding behind. If it wasn't for that, you'd be depressed 24/7. That's impossible. If you were depressive all the time, you'd probably die.

Hi @erh.germany :D

You see how now I am talking to my reader? Does my new writing style look familiar to you :D
Well, thank you once again for inspiring me to make this change!

Ok, so let's talk about this most interesting comment you left for us here. But really what I have is a question for you: do you agree that the outer conditions/circumstance and inner perception/evaluation are to an extent the factors that CBT puts forwards as the ones which influences the meaning we attach to the situations?

I personally think so :D

The outer conditions/circumstance reminds of of what CBT puts as the overall context of the individual. And the inner perception/evaluation makes me think of what CBT states to be the overall context of the individual and also the individual's personal history (maybe not the latter!).

I have learned that. In the past, I tended to intensify the negative feelings by thinking and worrying (more of the same)

Yep, the cycle of negative thoughts! One can get seriously stuck in such pattern. I still have to police myself to not get stuck in it! Like you said, in my case too this ability seems to have becomes less difficult as I get older and see that the bad times do not last forever :)

Ps: I loved your post about Alan Watts and YES I would love you to continue that series. I am sorry I haven't left a comment. But, I do hope you know I am a constant reader of your work and a big fan of your blog as I learn so much from you! I constant send people to you (including here on my comments!).

Lots of love to you EriKa

I thank you, Abigail!

You see how now I am talking to my reader? Does my new writing style look familiar to you :D Well, thank you once again for inspiring me to make this change!

Yes, I felt very much talked to:-D - you are always welcome and I I feel flattered.

Funny how we promote each other. I was name dropping, too! :-) In the chat as well as in comments.

do you agree that the outer conditions/circumstance and inner perception/evaluation are to an extent the factors that CBT puts forwards as the ones which influences the meaning we attach to the situations?

Oh, yes, I do agree on that. The CBT sounds totally sensible and logic to me.

Yes, if that is meant by the overall context, then this kind of treatment for sure integrates many things which are significant to consider.

I must add that no matter what kind of treatment one gets, if it heals and leads to a better situation, it is right.

Also one can have the best treatment/method but if the relationship between client/patient and counsellor/doctor is accompanied by distrust, insecurity and prejudices, it's of no or little help. But for sure you've heard that already hundred times and talked about it, too.

I am glad that you talk about the same experience and getting more calm within the years. To deal with this kind of profession and topics for sure is helping, I find.
At least for me its of utmost advantage:)

Oh, Thank you so much for mentioning my Watts article. I adore him! It pushes me to continue. He is one of the most fascinating men I've ever stumbled upon.

I send you Love & Affection! <3

I have personally gone through a prolonged process of CBT myself with regards to addiction. I believe that the value of CBT lies in its ability to help a person slowly regain control over once uncontrollable thoughts, reactions, emotions, etc. and being allowed to rewrite cognitive journals where within we start jotting down positives, too.

Although it is not explicitly stated I would argue that Mr B's response to the events in his life, which resulted in his depression and suicidal tendencies, was something he was already susceptible to and was merely triggered by the events leading up to and after the divorce (along with other relevant events).

Going through something like that renders a person feeling completely powerless. The co-morbidity of OCD would only contribute to these feelings of powerlessness as compulsions are already psychosomatic impulses in response to wanting to have control over things (internal and external).

CBT allowed Mr B to recognize and reawaken that part of him which wanted to be in control, yet was drowned out by the depression. It is very important to note that it took a long time. Changing behaviour and thinking patterns is a prolonged process.

Continuing to your questions:

  1. Do you agree with the behaviourist notion that proposes that it is not the situation per se that causes emotional responses; but rather the meaning attached to it?

Yes. I liken it to where you state that in a negative emotional state people find it difficult to remember good memories. Conditioning is important. In Mr B's case we could argue that he avoided any relationships afterwards because of the change in his understanding and perspective on relationships after the divorce (and even prior to).

He is now possibly lonely and isolated but the though of meeting someone new conjures terror, rather than elation.

  1. Whenever you feel sad or anxious do you also resort to strategies that alleviate the symptoms of your difficult feelings?

It depends on the situation. Sometimes it is important to rather work through certain emotions instead of trying to alleviate them. It is important, to me, to understand why I react to things to way I do and why they stimulate specific emotions.

It is also important to distinguish between self-defeating emotions (responses) and emotions that offer an opportunity for self-reflection and growth.

Thank you for the well-written article. It really stimulated some brain matter on this side.

Please let me know if you see any error in my thinking! :)
@rionpistorius.

@rionpistorious, When I finished reading your comment I thought to myself: "Beautiful!" with a smile on my face. Thank you very much for taking the time to share this most incredible insight on CBT here with us.

I also appreciate the way you looked further into Mr. B's case. Byt the way, your answers to the questions I left at the end of the posts are actually quite similar to my own answer :)

Thank you for your most kind compliment!
All the best to you.

Awesomeness, looking forward to the next case-study!

When I read the paragraph below:

In CBT difficult feelings such as sadness (and anxiety) are seen not only as normal, but also as healthy reactions to the environment and life in general. However, when someone experiences such feelings in their most extreme, they can develop avoidant behaviour (for example, stop engaging in daily activities), which will inevitably distance them from family and friends; in turn, causing feeling of detachment that in most cases leads to suicidal thoughts.

I was reminded of someone from my hometown. About five years ago when I last visited home, I noticed that he kept a lot to himself. He lived in a big family house with hus siblings but he neither spoke nor associated with them most of the time. When I saw him this time, he had stopped opening his mouth entirely. When asked, the reason he offered for keeping his mouth completely shut was that people would poison him if he dared open his mouth long enough to speak. His isolation from the community started when his mother died of unknown causes. He chose to believe that it was his step mother and her children that were responsible for his mother's death. I'm not sure but I think the negative thoughts were in a spiral like you said:

Negative thoughts > triggering low mood > prompting more negative thoughts > lowering the mood further, and so back to the beginning.

I sometimes feel depressed and in those moments I have no desire to speak to anyone including those who care about me. I avoid them. What I found out, however, is that negative feelings beget negative feelings and so on. So for example, on my birthday, I felt sad because of the the things I had failed to achieve, so what I did was to recall all the things I did achieve and all the blessings I've had including the important people in my life. This helped me dissipate the negative feelings and a miracle happened - the positive feelings also came in a flood. So I believe that,

it is not so much the situation that prompts emotional reactions; but rather the meaning that the person concerned associate to it.

Two people can gave the same experience and while one would allow the experience to weigh him or her down, the other person may choose to see it as a challenge that can be overcome, an opportunity for growth. I am that second person.

You make psychology so interesting. Thank you for this beautifully written post. Pay no attention to my typos: I just couldn't wait to send you my thoughts.

Awesome!

Hello @churchboy, what a beautiful comment you left for us here!

Thank you so much for illustrating the case of your acquaintance. I find illustrations like yours particularly important specially when combined with all the info we are gathering here. This is, of course, because I have the hope it will enlighten people and bring them some understanding should anyone of us encounter such cases in our lives, with a family member, friend etc..

so what I did was to recall all the things I did achieve and all the blessings I've had including the important people in my life. This helped me dissipate the negative feelings and a miracle happened - the positive feelings also came in a flood. So I believe that

I could not thank you enough for sharing your very, own experience with adopting such approach. I know it is not easy. I, personally, find quite difficult to think positively in moments of sadness. This serves as a great encouragement (truly appreciate it!)

I also agree with this behaviorist view that difficult feelings do arise from the meaning given to the situation, and you have illustrated this further with a very-straight forward example, that I believe all of us have encountered at some point in life. How many times haven't we thought 'Oh that was awful'! Just to hear, let's say a friend reply 'it was not that bad!'.

I am glad to hear you are one of the few people who can overcome difficulties and see them as opportunities. Hence, your most insightful, inspirational comment! Beautiful.

Thank you so much for you most kind, encouraging words about my work. You have a very positive energy! All the best to you :)

Thank you so much for having the time to reply my comment. I don't know how you manage to have the time. Yes, it is really difficult to leave negative feelings behind and catch on to positive feelings, so to speak.

I have had some practice with it and I get better each day. I hope to read more of your insightful posts about the work you do with people, helping them. You're totally awesome.

You are spoiling me with your kind words!

Somebody has got to do it and it is my singular honour :)

Do you agree with the behaviorist notion that proposes that it is not the situation per se that causes emotional responses; but rather the meaning attached to it?

I do agree; a terrifying life situation might happen to two people, the severity of the effect on the people depends on how they see it(attaching meaning to it)
For instance, personally, have run into some unhealthy relationship with friends and families members that almost cost me my life. As i thought i was ignored and not loved, sometimes lead to depression and low esteem. Until i looked for help. I had to understand that these things were normal, and my perception of some things are not correct.
Hope am still inlined with the question

Whenever you feel sad or anxious do you also resort to strategies that alleviate the symptoms of your painful feelings?

Sure most times, i tend to move away from the place or people that instigate the anger and anxiety

Nice write-up, love your analogy using Mr. B. I do understand it.

Hi @tormiwah :)
I am so happy you liked the analogy! I really appreciate you pointing this out :)

Hope am still inlined with the question

It was really interesting for me to read your particular, personal example and also self-analyses. I suppose we all go through what you did at some point in life. Some in a greater extent than others, but then again, it seem to be, in the end, down to the meaning we attach to it.

Thank you for this beautiful feedback @tormiwah
Best!

Yea making the post entertaining and having the readers in mind, the analogy surely fulfill that. Kudos to erh.germany for stimulating that. Will surely try to imorove my post also.😀

Great post, once again!

I would like my readers to accept is that psychology is not a field entrenched within the boundaries of psychoanalysis, and that talking psychology goes way beyond than talking Sigmund Freud and Carl Jung.

I think you're doing a fantastic job to prove that statement!

At the end of the 21-month-treatment, Mr. B, who had been completely avoidant, had finished a technical course, was about to start a six-month computer training, and had two potential job positions awaiting him.

I would call that a miracle treatment for it to work in such a short time.

Psychoanalysts argue that what this most likely will do is to actually make the ´suppressed´ symptom reappear in the form of ´neurosis´.

But then what if the symptom was not suppressed but eliminated? That would result in a complete cure.

Do you agree with the behaviourist notion that proposes that it is not the situation per se that causes emotional responses; but rather the meaning attached to it?

Depends upon the state of mind of the person and the way he perceives the situation. Yes, the meaning attached to the situation(in the person's mind) is of significance.

Whenever you feel sad or anxious do you also resort to strategies that alleviate the symptoms of your difficult feelings?

Good question! To answer it from a personal point of view, I have started doing it in the recent past, especially after I started flying off the handle at the touch of a button. Things are much better now, after I have learnt how to alleviate the symptoms. Hey, maybe I can be your client one day! ;-)

Ahahaha @maxabit! It made me so happy to hear you think I am doing well with broadening people's views about psychology! It made my evening :D
It is also great to hear you have managed to get yourself in check! We all need to self-evaluate every now and then.
Lots of love to you & thank you for your most invaluable support!

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