Monday, June 1, 2009

Cognitive Behavioral Therapy -- aka Cake or Death

Cognitive-Behavioral Therapy (CBT) is a... treatment that focuses on patterns of thinking that are maladaptive and the beliefs that underlie such thinking...  In CBT, the individual is encouraged to view such beliefs as hypotheses rather than facts and to test out such beliefs by running experiments.  Furthermore, those in distress are encouraged to monitor and log thoughts that pop into their minds (called "automatic thoughts") in order to enable them to determine what patterns of biases in thinking may exist and to develop more adaptive alternatives to their thoughts. -- NAMI.org 

Books on Cognitive Behavioral Therapy

A lot of self-help books for depression, anxiety, panic, Post Traumatic Stress Syndrome (PTSD) include CBTHomework is central to this therapy.  They give you worksheets to fill out, to monitor automatic thoughts, identify negative beliefs and test them.

Those work sheets remind me of my first experience of therapy, in the "Mental Hygiene Department" of Health Services at Yale University.  Every time I walked in that door, I thought about flossing between the lobes.  The thing is, CBT homework strikes me as even more tedious than flossing.  Once I realize I am having a thought that my therapist will not like, I would just as soon not dwell on my failure long enough to do the worksheet.  So I have three of those Depression/Anxiety/PTSD for Dummies books on my shelf.  But I have never, ever done my homework.

I used to do my homework all the time.  Pleasing people in authority was very important to me, and I was very good at it.  It still is, and I still am.  In fact, that’s the issue I am working on in therapy right now.  So I am not going to please my therapist by doing worksheets.  I think this is progress.

Computer Game for CBT?


I wonder.  If the CBT people could come up with a computer game, would that get around the homework aversion that some negative thinkers have?  What about Frogger?  Your avatar tries to cross the road while cars (“you’ll never make it”) and bicycles (“nobody even sees you”) and eighteen-wheelers (“come to me, come to me, you’ll never feel pain again”) whiz by.  The little frog gets points for dodging, depending on the speed and lethality of each vehicle.  The median could be a safe zone to rest and power up, like the therapist’s office.  But once across, there is another day, another road to cross.  Too many glancing blows from bicycles and Minis, or a single direct hit by a bus, and your little avatar keels over with x’s for eyes.

I don’t know.  That death scene might be mesmerizing.  You could end up practicing the wrong thought!

The other day I was reading the Crazy Meds blog.  Which directed me to Cake Wrecks.  Which is how I found Cake or Death.  Though for the life of me, I can't reconstruct how I got from the second to the last.  Cake Wrecks is fun.  But Cake or Death is my new venture into correcting my maladaptive thought patterns.  I figure if I watch this video two or three times a day and practice choosing cake, then a new thought pattern will hack its way through the kudzu in my brain, and I will create a different automatic thought.  When I see the eighteen-wheeler bearing down on me, I will step aside to find out if it's from Hostess or Sarah Lee.



What do you think?


Like Moses said, Choose Cake.

homework photo by Arvind Balaraman

edited and reformatted 11/27/10

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