“The cradle rocks above an abyss, and common sense tells us that our existence is but a brief crack of light between two eternities of darkness. Although the two are identical twins, man, as a rule, views the prenatal abyss with more calm than the one he is heading for.” (Vladimir Nabokov)
Rethinking “Shoulds” and “Musts”
Sometimes we are our own greatest enemies. We imagine that the world outside of us is “unfair” and we go on to create our own internal anxieties, bitterness and sense of injustice. How does this happen?
One way in which we create a sense of injustice is through our “should” and “must” self-talk. Examples could include:
“I am nice to others, so they should (or must) be nice to me.”
“People should treat me the same as I treat them.”
“If people are not always considerate, then they must be bad people” (Note this addition of the word “bad”, which serves to further polarise your thinking.)
“People must consider my feelings.”
All of these thoughts have the similar thread of an expectation of others, which is internally codified – or made a law of ethical action. Inevitably, people will not live up to this internalised expectation and then we end up feeling frustrated, manipulated, let-down, depressed and otherwise disheartened. What is the problem with this situation?
First, people do not have the same value systems that we do.
Second, others cannot read our minds to understand our expectations of them (and even if they could, we couldn’t expect them to always abide by our wishes).
Third, we are imposing our values on others, which does not take into account their individualism, free will and autonomy.
Four, we are setting ourselves up for disappointment and depression.
John – An example of “musts”, “shoulds” and anger:
John had been married for five years and was finding his relationship with his wife, Amy, to be on shakey ground. The first two years of their marriage had been a positive experience for both John and Amy, but in the last three years, they had found themselves becoming increasingly argumentative and hostile to the opinions of the other. Every day now seemed to involve arguments and bad feelings.
What was a cause of this change?
After they had been married awhile, John began to interpret Amy’s actions towards him as being insensitive. He had the philosophy that, “If I am nice and considerate to others, then I should be able to expect the same behaviour from them.” So, anytime Amy seemed less than considerate, John became angry – he would consider his reaction to be “righteous indignation”. Amy couldn’t understand what was happening with John. From her perspective, she had mellowed a bit and become more confortable with their relationship and was not being inconsiderate, but simply enjoying her life with her husband. She could make no sense of John’s outbursts and after a short period of patiently taking his abuse, she began to respond in kind. Thus began a dysfunctional pattern of relating which was now such a major part of their interactions and which threatened to tear their marriage apart.
What was done about their difficulties in relating?
John sought counselling with a cognitive behavioural therapist and began to consider his rigid thinking. He began to see that thinking in strict or absolute terms – “should” or “must” – was the basis of his marital and many other relationship difficulties. His earlier philosophy of, “If I am nice and considerate to others, then I should be able to expect the same behaviour from them” changed to something more flexible:
“I should try to be nice and considerate to others and sometimes people will return this effort in kind and sometimes they will not. It is not realistic to expect everyone to be considerate. Behaving well is its own reward.”
John soon noticed that his relationship with Amy was improving and his anger towards her and others was diminishing. He felt less wronged by others, more willing to overlook their imperfections and his anger problem soon no longer seemed to be a problem at all. Other people reacted positively to John’s change and his life became better at home, work and in social environments.
What does all of this suggest?
John was trapped by his own expectations. Yes, he assumed these expectations were reasonable and in a perfect world they might have been, but we do not live in a perfect world. John found his life improved not by trying to change others, but rather by reconsidering his own thoughts. Cognitive Behavioural Therapy (CBT) is involved in analysing our thoughts to see how reasonable and helpful these thoughts are and then making positive changes to our thinking – which then helps us to modify our emotions and behaviours.
If you, like John, are finding yourself controlled by absolute thinking which negatively affects your life, contact us to see how we can help.
All marriages are happy – Raymond Hull
“All marriages are happy. It’s the living together afterward that causes all the trouble.” (Raymond Hull)
Married men and mistakes – Red Skelton
“All men make mistakes, but married men find out about them sooner.” (Red Skelton)
Indecision is a choice – William James
“When you have to make a choice and don’t make it, that is in itself a choice.” (William James)
Living is easy – John Lennon
“Living is easy with eyes closed.” (John Lennon)
To be yourself – Ralph Waldo Emerson
“To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment.” (Ralph Waldo Emerson)
Married and finished – Zsa Zsa Gabor
“A man in love is incomplete until he has married. Then he’s finished.” (Zsa Zsa Gabor)
Meta-analysis of effectiveness of Cognitive Behavioural Therapy – Butler et al
In conducting a meta-analysis (examining the research findings of others regarding Cognitive Behavioural Therapy effectiveness), Butler et al found that in many cases, CBT is an effective form of treatment for a variety of psychological issues:
“In this review of 16 recent meta-analyses we sought to answer a multifaceted question: How effective is CBT [Cognitive Behavioural Therapy], for which disorders, and compared to what, and how lasting are these effects? Collectively, the findings detailed in this review suggest that CT [Cognitive Therapy] is highly effective for adult unipolar depression, adolescent unipolar depression, generalized anxiety disorder, panic disorder with or without agoraphobia, social phobia, PTSD [Post-Traumatic Stress Disorder], and childhood depressive and anxiety disorders. The comparison-weighted grand mean effect size for these disorders when compared to no-treatment, wait list, or placebo controls is 0.95 (SD = 0.08). CBT is associated with large improvements in symptoms for bulimia nervosa, and the associated effect sizes (M = 1.27, SD = 0.11) are significantly larger than those that have been found for pharmacotherapy. CBT also has shown promising results as an adjunct to pharmacotherapy in the treatment of schizophrenia. The average uncontrolled effect size of 1.23 for CBT compares favorably with an ES of 0.17 for schizophrenic patients receiving only routine care. Moderate effect sizes (M = 0.62, SD = 0.11) were obtained when CT was compared to controls for marital distress, anger, childhood somatic disorders, and several chronic pain variables (i.e., pain expression behavior, activity level, social role functioning and cognitive coping and appraisal). CT was somewhat superior to antidepressants in the treatment of adult unipolar depression (ES = 0.38). CT was equally effective to behavior therapy in the treatment of adult depression (ES = 0.05) as well as obsessive-compulsive disorder (ES = 0.19). Trauma-focused CBT and EMDR were equally effective for PTSD. The efficacy of CT for sexual offending is relatively low (ES = 0.35). However, along with hormonal treatments, it is the most effective treatment for reducing recidivism in this population. Finally, CT was found to be superior to supportive/nondirective therapy in the few occurrences when these two treatments were directly compared. This includes two comparisons for adolescent depression (ES = 0.84) and two comparisons for generalized anxiety disorder (ES = 0.71).
We also aimed to provide answers regarding the degree to which the effects of CT persist following the termination of treatment. The meta-analyses reviewed strongly suggest that across many disorders the effects of CT are maintained for substantial periods beyond the cessation of treatment. More specifically, significant evidence for long-term effectiveness was found for depression, generalized anxiety, panic, social phobia, OCD, sexual offending, schizophrenia, and childhood internalizing disorders. In the cases of depression and panic, there appears to be robust and convergent meta-analytic evidence that CT produces vastly superior long-term persistence of effects, with relapse rates half those of pharmacotherapy. In addition, CT appears to show greater long-term effects in the treatment of generalized anxiety disorder as compared to applied relaxation.“
Butler, A. C. et al. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26, 27-28.
(Source: http://scholar.google.com/scholar_url?hl=en&q=http://www.floridaanxietyclinic.com/Handouts/ReviewOfMetaAnalysesCBT2006.pdf&sa=X&scisig=AAGBfm2VooNVChTjr8m8Y5z0E1_x3i_Qjg&oi=scholarr, Accessed 19 Dec 2011)
Learning to die – Leonardo da Vinci
“While I thought that I was learning how to live, I have been learning how to die.” (Leonardo da Vinci)