Thinking Errors

Many people have been asking about us and I wanted to tell you that we feel your love and concern and really appreciate it!  

Great news: 

Chloe is set to graduate from the clinic on July 18^thand we couldn’t be more proud of her.  She has truly been an inspiration in how hard she has been working to get better.  We know that these trials are helping her to help others some day and I can't wait to watch her soar!

 Carter has also been going to the clinic once a week for social anxiety, but will begin IOP on a daily basis as soon as Chloe is done.  This means we will still be spending our days at the clinic which can be a bit disruptive to life but I don’t care because I love it!  

I can truly say that we are all doing better than ever.  How could we not be with a place where kids and parents can learn together, cry on each others’ shoulders, support each other and even laugh at our crappy lot in life?  We have family therapy, individual therapy, support groups and most importantly we are being trained and drilled in how to handle all kinds of mental health issues and it is glorious.  If I have an ocd question or situation, a parenting question, a marriage or relationship question…there is a professional at my beck and call every single day to hold my hand and walk me through the issue.  

 I know it sounds crazy, but I keep telling people that this is the 

“BEST worst thing that has happened to us.”

 And I truly mean it.  

We have had access to some of the best mental health care and tools around and our newfound understanding has given us the world. Our family, our happiness, our relationships, our parenting have all improved because of these tools.  What makes me sad is that it took something so bad (a breakdown/suicide attempt) to get us into the position to really learn and practice these things.  

EVERYONE should have these tools.  We ALL need them so badly!  Why aren’t these things more available to us?  They should have been taught to us when we were children. Our children should be learning these things while they are young and so many lives and families could benefit.  

I demand an improvement!

What is our society’s problem?

I don’t think it’s a new idea that total health includes mind, body and spirit is it?

When I look at our country, I see that we get the importance of physical health.  There is a big push on teaching children about physical health.  There are PE classes in school.  There are gyms and personal trainers, nutrition advice and so many diets and workouts available.  Heck, you can’t graduate from high school without Physical Education credits and without taking health class.  It’s MANDATORY.  We get that physical health is important.

Our country also seems to get the need for spiritual nourishment.  For those who chose to embrace spirituality, there are also many options and tools for building spiritual strength.  Churches, temples and seminaries of all kinds exist.  People practice meditation, yoga, praying and religious rituals.  In my church we have many programs including Young Mens and Young Womens, Sunday School, and the Come Follow Me program which provide opportunities to build and maintain spiritual health.  You don’t need to look far to find access to all kinds of physical or spiritual health resources.  

So WHY then, 

 when it comes to building and maintaining mental health and wellness, are resources so limited?   What kinds of easy access to resources do parents have to teach these things?  

Hardly anything!  

Not okay!

I will say that our wonderful school counselor tried this year to teach the kids some mental health practices, and it was a start.  But it's not nearly enough.  I also see some teachers are trying to introduce some mental health skills in their classrooms as well and bless them for doing it.  But as a society in general why do we seem to place such little value on mental and emotional wellness?  Where is my mental health fitness center?  Where are the mandatory or free mental health education classes in the schools or for the general public?  

The more I think about this the more infuriated I become.  I was curious about WHY this is… so I did a little reading.  I found that it’s not only an issue in our country, but WORLDWIDE. 

One article had some theories that made sense. Here’s a bit of what it said:

Patel, a psychiatrist at the London School of Hygiene and Tropical Medicine, said,“Given its contribution to the global burden of disease, mental illness receives nowhere near the kind of attention and resources it deserves."

Why is mental health largely ignored on the global health agenda?

“Frankly, I don’t know,” said Patel. “The level if disinterest and apathy surrounding this massive problem is mysterious to me.”

Some of it clearly has to do with the stigma that still surrounds mental health, he said. Many people still tend to view mental illness as a character flaw, Patel said, as something that an individual is somehow personally responsible for having and for not being able to control their behavior.

Because of this misunderstanding, he said, many people with mental illness in poor communities (and not-so-poor, but ignorant, communities) suffer severe abuse.

“In developing countries, it is not uncommon to find people with serious mental illness chained up, locked away or subjected to regular, outright abuse, even in health care institutions,” Patel said. “If any of us saw even one individual with HIV/AIDS treated like that, there would be global outrage … But you don’t see the same outrage when it is people with mental illness.”

Something must be done and I’m all fired up about it.  FIRED UP!!!   But wait, I need to check myself.  First, I need to focus my energy on getting my kids better, but mark my words, when they are doing well I am going to fight to fix this problem…even if it just means teaching what I’m learning on this blog, or applying these tools in my future classroom.  Or maybe I’ll eventually rally on a bigger scale, who knows?  

Until then, I want to share for others.  There are so many things we have learned.  I want to start with a topic that has been life changing for my family and me: THINKING ERRORS.  

Thinking errors are thinking traps that influence our happiness and can push us into depression or anxiety.    We all do them.  Our mental well-being depends on our ability to manage our thoughts, regulate our emotions, and behave productively and responsibly despite our circumstances. This can be a challenging task for all of us at one point or another. But learning to recognize and manage our thinking errors will go a long way in helping us build mental strength.

According to a Webmd article, thinking errors “can skew your judgment and make it hard to appraise your situation realistically." (2002)

We as a family are practicing and working daily to identify these thinking errors and correct them.  As you read these, I challenge you to recognize which thinking errors you or your children may be using and how they are negatively affecting your life.    

THINKING ERRORS  (Also called cognitive distortions)

• All or nothing thinking:  You don't see middle ground. You assume if you don't get the promotion, the company wants to ease you out the door. 

• Overgeneralization:You extrapolate your future based on a single event. You figure that if you failed the bar exam on the first try, you're just not cut out to be a lawyer. 

·      Mental Filter:  Only paying attention to certain types of evidence. Noticing our failures but not seeing our successes.  

·      Disqualifying the positive:  Discounting the good things that have happened or that you have done for some reason or another.  That doesn’t count.

·      Jumping to conclusions:  There are two types:

Mind reading: Imagining we know what others are thinking.

Fortune-telling: You predict that things will turn out badly, no matter what you say or do. Your new boyfriend does not call you as promised before a business trip, and you spend the week convinced he's breaking up with you. 

·       Magnification:(Catastrophising and miminalization)  Blowing things out of proportion or inappropriately shrinking something to make it seem less important. 

• Emotional reasoning:You get lost in your emotions. You spill food on yourself at a restaurant and feel like a jerk, so you assume other people see you that way, too. 

• Shoulds and oughts:You focus on other people's expectations of you, instead of on your own needs. You feel you ought to help a co-worker with his project -- even though it will make you fall behind in your work. 

·       Labelling:  Assigning labels to ourselves or other people.  I’m a loser.  I’m completely useless.  They’re such an idiot.  

·       Personalization:  Blaming yourself or taking responsibility for something that wasn’t completely your fault. Conversely, blaming other people for something that was your fault.  

For children especially, thinking errors are a destructive habit to get into, because they prevent them from learning the important skills that lead to success in life.

As I have been learning about thinking errors, I have two major questions:  

1.  How can we change them?  and

 2.  Why do they happen, or how do they form?

At the OCD and Anxiety Clinic, they work with clients on how to overcome these within the scope of their diagnoses.  I’m just curious in general, as a whole, how would someone like me help my kids or help myself change these thinking errors?  

Here’s what I’ve found:

1.     Identify your thinking errors as you use them.  Practice distinguishing between negative and accurate thoughts.    At the clinic, they have a form that you are supposed to fill out when you find yourself feeling anxiety.  As your SUDS levels go up, you write down the thoughts you are having in the first column of the form and more often than not they are thinking errors.  In the second column you identify at least two thinking errors that could go along with those thoughts you are having.  In the last column you challenge the thinking error by collecting evidence to support or negate the thought, challenge it, and brainstorm an accurate thought to replace it.    The repetition of doing this really helps to change the way you think.  

 Here's an example

Anxious thought:  "I can't speak in front of a crowd because everyone will judge me and think I'm stupid if I make a mistake or sound dumb."

At least two thinking errors in that thought would be:  Mind reading, and overgeneralizing

Challenge the thought:  What is the likelihood of EVERY single person judging me?  What is the likelihood of NO ONE judging me?  We can rule those two out as not realistic.  What's left is that maybe one or two people might judge me.  Maybe they will or won't think I'm stupid but I at least know that ____ knows I'm not stupid.  I know I'm not stupid.  My teacher knows I'm not stupid.  etc.  

Hopefully, anxiety about the situation will decrease after this exercise.  

2.    Cultivating optimism

Parents can play the “Unfortunately, Fortunately” game with their kids. Together with your child, come up with “five sticky situations,” which you write down on cards and put in a hat. Each person then pulls out a card and says the unfortunate situation (Chansky uses the example: “Unfortunately, the movie I wanted to see was sold out”). The other person responds with a fortunate perspective (“But fortunately, I went to see another movie”). Then you go back and forth, each mentioning unfortunate and fortunate circumstances.

The next time your child is going through a difficult situation, you might say, according to Chansky, “There are a lot of ‘unfortunatelys’ stacking up. Can we see if there are any ‘fortunatelys’ in this situation?”

3.    Building distance from negative thoughts.  Teach your child to be a thought detective.  Avoid saying they are being negative, instead blame the “negative brain”. (This also makes you an ally in helping defend your child against this ‘troublesome third party).  This relabeling “begins to demote the validity of negative thinking, encouraging the child not to trust it as the truth but  According to Chansky, this relabeling “begins to demote the validity of negative thinking, encouraging the child to not trust it as the ‘truth,’ but as the annoying, upsetting, overprotective or just sort of ill-informed voice that it is.” You can brainstorm ways to talk back to that negative brain: “You’re not the boss of me; you make me feel bad; I’m not listening to you!”  

Other helps:  If you have a child with anxiety, you MUST READ  THIS ARTICLE they gave us at the clinic!!!

“9 Things Every Parent with an Anxious Child Should Try” by Renee Jain, Feb. 2018

On to causes:

What the heck causes people to form thinking errors?:  

Biochemical or physiological conditions:  We sure get this one.  Sadly, my kids don’t stand a chance with the crappy genetic combination my husband and my genes created.  Being genetically predisposed to anxiety and OCD automatically predisposes them to forming thinking errors.  

Cultural and social factors:  We can pick up thinking errors and cultural biases from society. This includes the fast-paced nature of our society.  People need time to examine, question and test their thinking.  If people are placed in a fast-paced environment they are forced to use oversimplified thinking and therefore will have more thinking errors.  Slow down everyone!  

Habits and attribution bias:  If a person thinks a certain way for a long time, it can make it more likely to keep thinking that way.  

Fear, anger and conflict:  Being overly exposed to any of these things can create thinking errors.   

Other articles I’ve found about this subject:

https://blog.cognifit.com/cognitive-distortions/

https://www.quora.com/What-is-the-underlying-cause-of-cognitive-distortions

Isn’t it fascinating?  If anyone has any success using any of these suggestions, I’d love to hear about it.  And I LOVE all of your comments.  Thank you so much for taking the time to reach out, even if it’s just a line or two. It lifts me more than you know!  

Love you all,

Molly

References: 

Arnquist, Sarah.  (2011). Why is Mental Health Largely Ignored on the Global Health Agenda? Retrieved from:  https://www.ghdonline.org/ncd/discussion/why-is-mental-health-largely-ignored-on-the-global/

Tartakovsky, Margarita.  (2018) 3 Handy ways to help your child overcome negative thinking.   Retrieved from https://psychcentral.com/blog/3-handy-ways-to-help-your-child-overcome-negative-thinking/

WebMD  (2002).  Fixing Common Thinking Errors.  Retrieved from https://www.webmd.com/balance/features/common-thinking-errors.

SUDS

This new acronym has become a part of our daily language in our battle against Chloe's OCD relapse.  

S-U-D-S

It seems like such a harmless little word, like a bunch of cute little sudsy bubbles.  

Don't be fooled!

It's the opposite of cute.  In OCD world, SUDS stands for:

Subjective Units of Distress Scale

and it rules/dictates our lives at the moment.  

High numbers are BAD.  BAD things happen when SUDS are high in our family.

Spend some time with our family and you will constantly hear things like

"What are your SUDS?"  "How are your SUDS?"  "Where are you on your SUDS?"  

Similar to a pain scale, our SUDS are without the extra zeroes in the picture, just 0-10. 

Chloe uses the scale every day while completing her hours of ERP exposure response prevention at the clinic, and then during her exposure homework at home.  And we also ask her at bedtime which is when OCD gets bad, and SUDS get high.  We all have a plan that we now know very well and implement those things which I will talk about later.  

If you remember from our first time I blogged about treatment, exposures are what Chloe does to intentionally place herself in a situation where she is likely to feel vulnerable to a perceived threat.  

Response prevention  means that she must engage in the exposure with absolutely 

NO NEUTRALIZING BEHAVIORS.  

Exposure based therapy aims to turn avoidant behaviors into opportunities to intentionally approach situations perceived as a threat.  The goal is a natural reduction of distress over time with exposure to the perceived threat.  Each time Chloe intentionally exposes herself to something , her alarm system/brain learns that it's safe and not worthy of alarm.  

Kate has created a hierarchy of exposures that starts with  small exposures and gradually getting harder and bigger.  Chloe spends one, sometimes two hours each day in IOP with a Clinical Assistant doing her exposures.  As she performs an exposure, she tells the CA where she is on her SUDS.  It's usually high at the start.  As she continues intentionally exposing herself to that threat, her body starts to learn that there really isn't any danger at all, and the alarm begins to lesson.  SUDS numbers are lower.  When SUDS are consistently low for that particular exposure, she moves up to the next level on her hierarchy.  

First exposure on the hierarchy for Chloe was making origami.  

For a person without perfectionism OCD, that seems so ridiculous, doesn't it?  But learning to fold origami involves lots of mistakes, and making mistakes is a perceived threat that causes Chloe's brain to set off the alarm system.  After creating origami for hours and hours, days and days, eventually the alarm system in the brain figures out that there really isn't any threat there.  SUDS go down.  

Next step, she had to learn to crochet.  

Once again, she wasn't perfect at it.  Lots of mistakes.  SUDS were high at first.  After hours and hours of crocheting, SUDS got lower and that level of the hierarchy was complete.

Next step she had to do speeches in front of the CAs.  They had to be off-the-cuff unprepared two minute speeches without any pre-preparation.  Feeling like she isn't smart enough is one of her most prevalent intrusive thoughts.  She is a lot like me - we are smart but we need to take our time and work hard at getting good grades.  Kids at school are almost always making comments on other kids' grades and/or how long it took someone to finish, or how easy/hard the assignment was.  These kinds of comments are almost always grabbed onto by obsessive intrusive thoughts of not being good enough, not smart enough, not fast enough, not a good speller.  

These exposures brought her SUDS higher initially and took much longer to get to a lower level.  But,

SUDS were high....eventually SUDS got low.

Next step, she had to debate with the CAs at the clinic and family at home about things she didn't know much about, and which the other person knew a lot about.  No pep and she didn't get to choose the topic.  

Now she is currently working on learning songs on the ukulele in front of the CAs.  You make lots of mistakes when you learn a new song.  She's been doing this one for quite a while, but as a bonus is getting awesome at playing the ukulele!  

She is getting close to completing her hierarchy for the theme of perfectionism.  Her body is learning that there is not a cause for distress and alarm when mistakes are made.  The top exposure on her hierarchy is participating in a spelling bee with the CAs.  Graduation may be around the corner.  

We are super proud of her.  She has been zooming through IOP this time because this time around she trusts the process, is willing, and wants to get better so she's doing the work with a good attitude and killing it!  In that way, it's much easier this time.  

But the bad thing about mental illness is that you can't always SEE the hard work or improvement in a physical sense.  If Chloe was in rehab and learning how to walk again, everyone could see her struggling to take steps over and over and over again.  You could see her legs getting stronger and beginning to work again.  People would be cheering her on and celebrating every little milestone and victory.  

In her OCD battle, we can't physically see just how hard the work is that she is doing but let me tell you, after doing a few exposures myself and experiencing the level of distress and strength it takes to get through them, Chloe is my freakin' HERO.  And the fact that she does them for hours every day and then comes home and does more...and still participates in normal life with a degree of pleasantness is mind boggling.  It is a testament to her will and character.  

Chloe's OCD and fears used to seem so strange to me, but when I think about it we all have unreasonable fears in some way or another.  They may even rule our lives without us knowing it.  For example,

The other day I had a situation where I felt very anxious.  My bedroom was a disaster and I had to take a proctored online exam for school in there.  Before taking the exam, I am required to show all four walls of the room with the webcam to prove that I don't have access to any materials with which I could cheat.  The thoughts of anyone seeing my exceptionally messy bedroom made me SUPER anxious and ashamed.  

Because I admire what Chloe is doing so much, I have been trying to join her in doing exposures myself.  I don't want to expect her to do something I'm not also willing to do.  So I decided that I would do an exposure and NOT clean my room before taking the exam.  

I also was NOT allowed to do any neutralizing behaviors which meant I couldn't apologize for the mess, explain that I am really a clean person or make a joke about my messy room to the exam proctor which is what I would normally do to try and make myself feel more comfortable.  

As I showed the proctor my room, I was surprised at how high my SUDS levels were.  I would say a 5 or even a 6 because I had physiological symptoms from the anxiety I felt facing that fear.  I got warm and very sweaty.  Afterwards, I was breathing heavier than usual and felt a little wiped out emotionally once the exposure was over.  

It seems like such a dumb thing but it challenged core beliefs that I have developed about cleanliness reflecting my worth as a person.  And allowing someone to see that made me vulnerable to judgment.

I worried that the proctor would make a comment but she didn't even care.  

What do you know?  The world kept on turning and there really was no danger.  Letting others see my weakness wasn't really cause for alarm, but I also recognize that I would have to do something like that many more times in order to change that anxious reaction and core belief.  

I also did an exposure at church this week.  I feel very self conscious about my new 40-something body and my "fat arms".  I usually wear three quarter sleeves to cover my upper arms because I think they look disgusting and I'm embarrassed by how much weight I have gained.  I wore a dress that reveals my upper arm area and didn't wear a sweater over it.  I noticed that while I sat in church I wanted to keep my arms down to hide them but I remembered NO NEUTRALIZING BEHAVIORS so I deliberately put my arm around my husband and kids, allowing the entire congregation full view of my fat arms.  

It was uncomfortable, but guess what...no one said anything to me and the world kept turning.  Hopefully I will keep putting myself in these situations and my brain will realize that letting people see my "fat arms" is NOT cause for alarm and anxiety.  

Lastly, I did an exposure at the gym this week.  I took a yoga class fully knowing that I had a hole in the butt of my leggings.  You can really see it because I wear white undergarments and the leggings are black.  I was going to throw them away because of the hole but decided to wear them as an exposure.  I must admit, sometimes the distress would get to me and I did a neutralizing behavior by tying my jacket around my waist to cover the hole.  

Not doing neutralizing behaviors is HARD!!!  It takes will power!

But then I would think, "No!  Chloe has to do this so I can too" and I would take the jacket off and deliberately walk in front of people. 

It was uncomfortable for sure but ...what do you know?  No one said anything and the world kept turning.  Having a hole in the butt of your pants isn't cause for anxiety.  

Even though I don't have OCD, this whole experience has really got me thinking about how much of my life is held back by fears - reasonable or unreasonable it doesn't really matter.  

I mean, I only have to go to a public pool to realize that there is a whole plethera of people that don't let the fact that they are overweight stop them from prancing around in a bikini and they don't even think twice about it.  They are having fun with their families without a care in the world and I'm too worried about covering the parts of my body that aren't in shape anymore to enjoy myself.

How many times have I not invited someone over or inside my home because my house wasn't tidy?  Or stressed out about cleaning my house to perfection before we go on a trip or have guests over?  How many times have I apologized for my house not being tidy?  

How many times have I felt distress because I spilled something on my shirt during the day and tried to cover the stain or apologize for it?  

That's TOO MUCH ENERGY spent on fears.  I don't want to do it anymore.  

I think of my small experiences then I think of Chloe and how much more intense these feelings are for her, and how much more the anxiety and intrusive thoughts affect her life and I feel so much compassion for her suffering.  I also feel so much admiration for her willingness to put herself through distress on a daily basis in order to get better and hopefully prevent relapses in the future.  On top of all of this, she still takes time to help the other youth in treatment along while just taking care of herself is A LOT to handle.  

I'm really REALLY proud of my girl.   

What fears do you have that are holding you back from your best life?  Or even just regular life?

What are your neutralizing behaviors?

For those of you without OCD, I challenge you to try doing an exposure without any neutralizing behaviors.  Rate your SUDS levels after doing it.  I think it would be awesome if anyone even wanted to share their experience with me or Chloe.  

Next entry, I'll post some of the strategies the clinic is teaching us on how to handle those anxious feelings when our SUDS are high.  It's good stuff.  

Until then...thank you again to everyone who has been sending their love and support.  It means the world to us and lifts us up.  We love ya!