My Therapy Journal

Creating a customized approach to therapy work

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This was a guest post I did for Johnzelle Anderson at Panoramic Counseling.

While unfortunately, I haven’t had much luck finding a therapist that I’ve had a good rapport with, that hasn’t turned me off the idea of therapy at all. Instead, I’ve put my knowledge as a mental health nurse to work, picking and choosing bits and pieces from different therapeutic approaches so that I can do my own work based on what resonates with me the most.

An important part of that is my therapy journal. It’s a combination of toolbox and therapy manual, and it helps to keep me on track and gives me good reminders when I’m starting to flounder. While I’ve got a separate journal that I use for everyday tracking, my therapy journal is super-focused.

Cognitive distortions, a key concept in cognitive behavioral therapy (CBT), make an appearance right at the beginning of my journal, along with notes around which ones I use most often and how I use them. Mind-reading is one that tends to come up over and over — I think that based on people’s responses I can tell what they’re thinking. By keeping track of the situations in which I do this, I’ve gained a lot of insight into my usual patterns. I’ve also got a page full of some pretty strongly ingrained distorted cognitions related to trauma, and I’m gradually working on chipping away at those.

In my journal I’ve paired cognitive distortions up with the acceptance and commitment therapy (ACT) concept of psychological smog. The “if onlys”, the reason-giving, the “I know why’s” that make up psychological smog all act as fuel for the cognitive distortion fire, and it’s a good prompt to add another layer when I’m considering my distorted cognitions.

I’m an avoider. It’s a strategy that has served me well at certain times, but at other times it’s much more problematic. Ideas from ACT have been helpful for me in conceptualizing this and recognizing how many problems avoidance is actually creating for me. I’m pretty good at recognizing my avoidance after the fact, but I’m working on calling myself out on it earlier on so I can shift gears.

From dialectical behavior therapy (DBT), the importance of validation really stands out for me. I’ve often felt invalidated by people who have legitimately tried to support me, as it can feel like they’re minimizing the legitimate challenges I’m facing. By reflecting on this, I’ve developed a much greater understanding of why I react the way I do, and I’m better able to realize that people weren’t intentionally trying to hurt me after all.

Another idea from DBT that I find useful is that we tend to have certain myths about emotions. As a result, we judge the emotions that we’re experiencing and determine responses accordingly. This has helped me to recognize my own strong emotion myth, that when emotions are too strong I need to hide. Obviously that’s not true, but recognizing it was an important step towards making changes.

From compassion-focused therapy, I like the idea that practicing self-compassion can boost what’s referred to as the “soothing and contentment system”, and this can help to tone down the “threat and self-protection system”. It’s not necessarily that novel a concept but framed in that way it makes a lot of sense to me and is a motivating factor to be more self-compassionate.

I like that there are so many diverse approaches to therapy because it really does mean that there’s going to be something that resonates with everyone. Combine that with a good therapeutic relationship and there’s tremendous potential for positive change.

Originally published at panoramiccounseling.com on September 20, 2019.

Mental health blogger | Former MH nurse | Living with depression | Author of 3 books, latest is Managing the Depression Puzzle | mentalhealthathome.org

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