It may surprise you how much of my job is spent dealing with guilt and self-hatred, which sometimes comes out as “I hurt myself today”.  People beat themselves up for having too much sex, for not having enough sex, for lying, for losing their tempers, for having panic attacks- the list goes on and on.  I’ve joked here before that rule number 1 in clinical sexology is whatever you can think of, someone gets off on it.  I guess it’s rule number one of psychotherapy that whatever conflict you can think of, someone is blaming themselves which results in hurting themselves. How do we hurt ourselves?  Well, again- you name it.  Cutting, self-medicating, sabotaging our relationships, starving ourselves, repressing our true selves or things that we have done in the past - these are all behaviors that can stem of guilt and shame.

Why do we beat ourselves up so much?  (“No No- we don’t go there.”) Who cares?!  The trick is for us to figure out how to stop shoulding all over ourselves and just accept that everybody has their shit.  I’ve talked before about the fallacy of perfection, but to me, that’s where all this self-loathing comes from.  I should be this but I am that.  I should have done this, but I did that.  No room for mistakes.  No room for corrections, even.  Just an oversimplified either or belief that perpetuates our feeling bad about ourselves and the behaviors that come from…you guessed it-  feeling bad about ourselves!  The more we then do these behaviors (like cutting, or smoking crack, or shopping) then the more we beat ourselves up, and the more we behave and and and the cycle keeps going.

I’ve been reading Damon Jacobs’ book “Absolutely Should-less”, and I really like how he teaches folks to just reword what’s going on.  Should implies this universal rule that is outside of ourselves we mistakenly believe holds true for everyone always.  Giving a statement so much power is bound to result in some unhealthy negative emotions (like guilt).  Take the statement “Argh- I shouldn’t have wasted all my time yesterday _______ing (fill in the blank- because whatever you can think of, someone is upsetting themselves about having done it.)  As soon as you say you shouldn’t have done it, you’re not living in reality (because according to you, you DID waste all your time).  You’re also implying that wasting time is bad, certainly wasting time blanking, because certainly no one else would ever want to spend time blanking instead of doing things they “should” be doing like immersing themselves in finishing their taxes from three years ago or prayer.

What would it be like to just reword the situation to “I could start budgeting my time” instead of “I shouldn’t have wasted all my time!”?  This allows for - Ok, that happened.  In the future, I can take responsibility for myself and instead of beating myself up over something I DID, I can learn to change the action and do something about it out of frustration and disappointment instead of sabotaging and hurting yourself out of guilt and self-downing.  What if, when dealing with something happening to you instead of saying “FML, that awful thing shouldn’t have happened to me!” and you could reword it (and restyle your thinking about it) by saying “That sucks that this happened to me, but it could have happened to anyone!”?  This simple rewording forces us to think about things in a different way, which really is the work your therapist is trying to get you to do.

Hurting yourself by not accepting your humanity makes for pretty songs and pretty emotional messes…and you can quote me on that.



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Cognitive Behavioral Therapy, or CBT: Tends to be directive and non-judgemental.  Teaches you how to identify how your thinking leads to unhealthy emotions and behaviors and how to modify that thinking to achieve healthy results.  Tends to be relatively short-term therapy. Oriented mostly towards the present and the future, although the techniques can be applied to past situations which may be unresolved.

Psychodynamic Therapy, or psychoanalysis: Tends to be passive.  This style of therapy attempts to answer WHY things are the way the are, with the hope that this insight will change the situation.  This style of therapy tends to be focused on unresolved past conflicts that may be influencing the person on a sub-conscious level.  This style of therapy is long-term therapy, and it is not unusual for the psychoanalyst to recommend that you come in more than once a week for several years.

Solutions Focused Brief Therapy, or SFBT: Tends to be directive.  This style, often used in couples counseling and family therapy focuses on what you want for yourself and how you are already making some of that happen, and how you can continue to get to your desired goal.  This style of therapy is relatively short-term be definition.  This style of therapy does not focus on the past.

There are hundreds of different styles of therapy and a lot of psychobabble and jargon used to describe and define those styles. There is no shortage of therapists in New York! Simply put, find a therapist you like and can be honest with about what you want.  Therapists aren't robots.  We also aren't irreplaceable.  Somone recently asked me how to find a therapist after their last one died.  My response- The same way you found that one.  You try a few on, and when it feels right, stick it out for as long as it is effective.

Modern psychotherapy isn't lying on a couch for four times a week for ten years and blaming your situation on your mother!  Cognitive behavioral therapy is relatively short-term therapy that produces tangible results.  Consider an investment in your mental health!  Are you ready for insight and change?

Though we let these traditions stress us out year after year, it is important to remind ourselves: this too shall pass.  Here are some common cognitive distortions (aka irrational beliefs, negative self-talk, stinkin' thinkin', etc) to watch out for to make it through the 12 days of whatever so we can ring in 2010 and get ourselves ready to do it all over again next year.

1. All Or Nothing Thinking: Often called perfectionism, this type of thinking is something along the lines of "I over salted the stuffing- dinner is ruined!". 
2. Overgeneralization: Look out for the alwayses and neverses "You always do this at my family's dinner.  You never treat anyone any good."
3. Focusing on the negative: The opposite of rose colored glasses.  You hear 57 comments about your chocolate babka, and one negative comment, and your life is over.
4. Discounting the positive: Similar to Number 3 in our list, discounting the positive is telling yourself (or others) that the positive comments don't count, and that anyone could have done just as well if not better.
5. Jumping to conclusions: Always a favorite.  "So your mother didn't like my green bean casserole.  I'll probably never get invited to bring a dish again!"
6. Magnification: "Well, I know I got this new promotion and won most likeable at the office, finished my dissertation, adopted three dogs and a cat, but I'm still a total loser for paying my credit card bill late this month."
7. Emotional Reasoning: Your feelings rule and define what's real and true for the entire universe.  Right?  "Ugh, tourists really piss me off for holding up the line at Macy's.  People from (choose your state) must really be total idiots.
8. Should Statements: We call this one "shoulding all over yourself".  "If you don't know how to run your metro card through the slot, you shouldn't be allowed to get on the subway during this time of year."
9. Self-rating: Labeling the whole of who you are with something you did, thought, felt, etc.  "I didn't impress your parents.  I am a failure."
10. Personalization and blame: Taking responsibility for things that aren't entirely within your control.  I think the same example applies " I didn't impress your parents.  I am a failure."

Sometimes this type of thinking happens. Keep it in check and challenge it if you notice yourself doing it, and you'll make it through.  At least until Valentine's Day.