The “ABC’s” of “CBT”
The shorthand edition of incorporating CBT into your arsenal of coping skills comes down to:
A: Activating event – which is anything that happens to you, large or small.\;
B: Your Belief about the event;
C: The Consequence of the event and your belief.
A simple example – watching a sporting event. When the event is over, we either feel good or bad depending upon our belief about the outcome. If our preferred outcome is realized we feel better than if it isn’t. Notice that our emotional response depends on our belief about the result rather than the result itself. After all, half the people watching are pleased and half disappointed regardless of the outcome or the fact that everyone saw exactly the same event.
As Epictetus (A.D. 50-130) noted nearly 2000 years ago, “What upsets people is not things themselves but their judgements about the things.”
Learning to manage our emotions, rather than feeling driven by them, goes a long way towards lessening the impulse to self-medicate the so-called negative emotions.
The trick here comes from understanding that CBT is not something that you go to a CBT Therapist to do – though there are plenty who will accommodate you on that regard – but rather a skill you practice, refine and internalize.
This skill acquisition is necessary because few of us recognize what our “B” – Beliefs – actually are, they have become so automatic.
Take road rage for example: Road rage occurs when another driver violates our personal “rules of the road” and we take this as a personal assault on what’s right.
Let’s evaluate the reality of another driver’s “tail gating.” First, what constitutes tail gating is subjective – there is no “rule” about how many car lengths of separation result in your comfort – no rule but your own which may not be shared by many other drivers.
Next, this “violation” of your comfort zone is not a personal assault on you. Let the offender pass and he/she will zoom up to the next car in exactly the same way.
No, you will not, by becoming angry and slowing down, teach them a lesson. Instead, you can just take a deep breath, move over and let them by, say “idiot,” and go about your travels without raising your blood pressure or endangering anyone else.
While this is a simplistic example it is one that comes up often and therefore is a decent starting point for discovering/testing your largely unconscious beliefs which are the ones which create anxiety, anger, panic attacks, depression, procrastination, and a host of other problems which can be largely alleviated by bringing our unconscious beliefs into consciousness (also variously called self-awareness, mindfulness, and other incarnations) and reprocessing them into more suitable – as well as rational evidence based ones.
Understanding the “Dance” of Self-Medicating
Our so-called “cravings” for alcohol are usually the convergence of three urges occurring at the same time.
Consider the traditional 5:00 p.m. cocktail hour.
For most of us, three different conditions are working together to give us the illusion that we “must” have a drink or three:
- Our blood sugar is low due to a long day and little or no lunch and our bodies are saying, “We need some sugar down here!” and our bodies see alcohol as predigested and readily available sugar;
- We really do crave the relaxing and blood sugar spike we get from a few drinks;
- We are replicating a familiar habit pattern that has become a ritual dance.
Broken down into its components, it makes sense to consider these 3 different “cravings” as being in need of different “fixes.”
Blood sugar management is the easiest to address: eat a decent lunch, have a 3:00 p.m. snack, moderate the “crash/spike” cycle and you eliminate one contributor to the 5:00 o’clock craving.
This will also lessen the “alcohol” craving as most of us are aware that when we start drinking, our appetite for food diminishes, just as eating lessens our appetite for alcohol. Funny how that works.
Finally, there is the ritual “dance” which constitutes our drinking pattern and is just as well-honed as any formal dance step. It’s why you can’t successfully quit or manage your drinking while everything else stays the same – no more than you can vary a particular well established dance routine but change only one step. In either case, you will trip yourself up.
Yes, we like our habits, routines, and rituals. And we don’t like the discomfort changing them always entails IN THE SHORT RUN! But remember, this week’s change becomes next month’s new habit. The discomfort of change, unlike the discomfort of maintaining an activity that has turned toxic, goes away.