Tag Archives: Cognitive Defusion

本森放松法 (The Benson Relaxation Method)

要素

  • 重复单词、声音、短语、祷告词或肌肉活动(muscular activity)。
  • 被动地、忽视各种想法(这些想法无可避免地出现在脑海中),并耐心地把注意力放回到你重复的点。

方法的总结:

  1. 选择一个单词(比如“一”、“和”)、短句或祈祷词。
  2. 安静地坐在舒服的位置。
  3. 闭上眼睛。
  4. 放松肌肉,逐步地从脚到小腿、大腿、腹部、肩膀、头部和脖子。
  5. 慢慢地、自然地放松的当儿,在你呼气的时候,在心里重复你的单词、声音、短语或祷告词。
  6. 采取被动的态度。不要担心你做的好不好。当其他想法出现时,简单地对自己说“哦…”,然后轻轻地回到你的重复点。
  7. 持续十到二十分钟。
  8. 结束时不要马上站起来。继续安静地坐上一分钟左右,允许其他想法自然地回来。然后睁开眼睛,站起来之前再坐一分钟。
  9. 每天练习一到两次。适当的时间是早餐前和晚餐前。

你也可以在运动时引起放松反应。比如你在慢跑或走路时,注意你的脚在地面上的节奏-“左,右,左,右”– 当其他想法进入你的脑海,说“哦…”,然后返回“左,右,左,右” 当然,眼睛要睁着!类似地,游泳者可以专注于他们的划动、骑自行车者专注于车轮的呼呼声,舞者专注于音乐的节拍,其他也可以专注于他们的呼吸节奏。
(改编自Don Robertson的AHPC培训手册)

11分钟放松录音

Neutral Pure-O

Most people know that Exposure Response Prevention (ERP) is the main intervention used for Obsessive Compulsive Disorder (OCD). So the rationale is pretty simple here, say we have a patient who is afraid of contamination (obsession) and wash his hands excessively (compulsion), we do some preparation work and can then start the ERP by exposing him to dirt without letting him to wash his hands (response prevention). This is normally done on a very gradual manner (with the patient’s consent and enough preparation work beforehand, so it is definitely not forcefully done to him). And of course in reality the OCD cases are barely as straightforward and simple as this, but this is the general principle.

With pure obsession, i.e. those without any compulsive behaviour, it’s all in their minds, things can get a bit harder, but still, it’s possible. Some commonly seen pure-O are (1) relationship obsessions (discussed in my blog else where as “morbid jealousy” which might or might not be the same condition), (2) sexual obsessions, (3) religious obsessions, (4) violent obsessions, (5) neutral obsessions.

So let’s take a recently seen man as an example here. It started once when he drove past a church, and somehow a sexual related thought popped out in his mind, he couldn’t bear himself having such “dirty” thought in a holy place, and since then, whenever he goes passed any holy places, he will suppress his mind from coming out with any “dirty thoughts”. And as we all know that our minds don’t work this way, the more you try to push some thoughts away, the more they bounce back and pop up.

ERP is possible for such pure-O cases. After the initial preparation work including psychoeducation and relaxation training, they are exposed to those thoughts that they have been avoiding, in those places (based on the items in the hierarchy). So it works similarly for all different types of pure obsessions, be it relationship, violent, religious or sexual (in certain cases where direct exposure is not possible, it will have to be done in imagination, and by watching videos etc).

However, how about neutral obsessions? What the patient has could be some really simple, random thoughts, which might be inconsistent, but they might be spending hours and hours thinking about these random stuff. Like a young man I saw couple months ago, who reacts to any thought his mind comes up with, e.g. “why does the universe work this way?”, “how do my ears listen and my brain comprehend what others say?” etc. I couldn’t really carry out typical ERP to him, since those are really random topics and they can be completely different every time. So I needed him to start thought defusion exercises, mindfulness meditation (then he dropped out…). I believe this is the best way for neutral pure-O, though I understand how difficult it’s to increase their motivation to keep practicing until they see the effects (did have patients in the past who were surprised by how quiet their minds can be after such exercises – and this is just a bonus, as it’s not the intention or purpose of such practices).

Do enlighten me if you have better psychological intervention for neutral pure-O. And I hope all the OCD sufferers out there will not give in to the illness!

The Benson Relaxation Method

The essential factors:

  1. Repetition of a word, sound, phrase, prayer or muscular activity.
  2. Passively disregarding everyday thoughts (which inevitably come to mind) and patiently returning to your repetition.

The method summarised:

  1. Pick a focus word, short phrase, or prayer that is firmly rooted in your belief system
  2. Sit quietly in a comfortable position
  3. Close your eyes
  4. Relax your muscles, progressively from your feet to your calves, thighs, abdomen, shoulders, head and neck
  5. Relax slowly and naturally, and as you do, say your focus word, sound, phrase or prayer silently to yourself as you exhale
  6. Assume a passive attitude. Don’t worry about how well you’re doing. When other thoughts come to mind, simply say to yourself “oh well,” and gently return to your repetition.
  7. Continue for ten to twenty minutes.
  8. Do not stand immediately. Continue sitting quietly for a minute or so, allowing other thoughts to return. Then open your eyes and sit for another minute before rising
  9. Practice the technique once or twice daily. Good times to do so are before breakfast and before dinner.

You can also elicit the Relaxation Response while exercising. If you are jogging or walking, pay attention to the cadence of your feet on the ground - “left, right, left, right” – and when other thoughts come into your mind, say “Oh, well,” and return to “left, right, left, right.” Of course, keep your eyes open! Similarly, swimmers can pay attention to the tempo of their strokes, cyclists to the whir of the wheels, dancers to the beat of the music, others to the rhythm of their breathing.

(Adapted from the AHPC Training Manual by Don Robertson)

Introducing “The Happiness Trap”

by Russ Harris

by Dr. Russ Harris

I completed this book in 2014. It was bought at Popular Bookstore at the price of RM34.90 (before 10% off for members). Just thought it’s really a good basic and entry book to Acceptance and Commitment Therapy (ACT) that I’ve been mentioning everywhere in my blog, also an easy read, and the chapters are really short. It definitely gives a grasp and basic concepts of ACT, using metaphors (so it can be a bit like reading stories!).

I’ve introduced and lent it to non-psychology backgrounds readers. What I realized is that they can usually get the ideas and benefit from them, but they don’t really know how to practice these concepts in real life (how to accept? how to defuse from my thought? etc). So if you get the ideas and are liking ACT after reading this book (just like me), you shall take a look at “Getting out of your mind and into your life: The new ACT.”

Introducing “Get Out of Your Mind and Into Your Life: The New Acceptance & Commitment Therapy”

Got this book from Kinokuniya, Kuala Lumpur in September 2015 (RM101.84).

By Steven C. Hayes

By Steven C. Hayes

I’ve been mentioning a lot about Acceptance and Commitment Therapy (ACT, see here for all the related posts), now finally, it’s an ACT workbook.

It’s written for the general public (especially those with pain and suffering), hence considerably readable though a lot of times it may go against your common sense. It talks about human suffering (why do we suffer? If we don’t struggle with the pain, is it still pain?), why and how language leads to suffering (do the birds or dogs think that they’re suffering? Or do they just feel it?), “experiential avoidance”, acceptance and willingness (how?!!), being the observing self (I really like getting in touch with my observing self, this is something that I tried to explain to my sister when we were much younger, it was a struggle because we didn’t have a term for it back then, but she got me), values (life direction) and committed action etc.

This is a workbook so there are plenty of exercises (meditation, mindfulness, getting detached from your thoughts/feelings, letting go, metaphors etc) in it, you will almost definitely find some that you like and some that you don’t quite like.

I’d recommend it to anyone, and especially to stick to and really hands on the exercises and practices (otherwise there’s no point to just “read” a workbook). If you have some suffering/pain that you’ve really been struggling with in your life (or in your mind, in a sense), it seems easier for you to practice the workbook. Nevertheless, if you’re like me – thinking you’re fine in general – it’d still be beneficial to go through and work on it.

Can you control your thoughts and feelings?

Many of the self-help books out there teach people how to change their thoughts, physical sensations, feelings etc in order to feel better (including traditional CBT which targets automatic negative thoughts), if you’re one of those who have tried many of these techniques, how workable do you think they are? Do you think you really have so much control over your thoughts and feelings?

Try these:

(1) Try to recall something happened in the past week, anything — a dinner you had, a movie you went, a talk etc. [continue when you've got one] Now try to remove it completely from your memory, get rid of it so you will never think about it again in your life… Can you do it?

(2) Now, do not think about chocolate. As you read this, do not think about how a chocolate tastes, smells; do not think about its colour and texture; do not imagine how it feels when it melts in your mouth and how it feels when your tongue and teeth contact with it. Is it possible? Try again with honey maybe?

(3) Think about past experiences, whether when you have to give a public talks and feel very nervous; when a loved ones passes away and you feel really depressed; when your results doesn’t come out as good as expected and you feel disappointed etc etc. You hope you aren’t that nervous, depressed, disappointed, you try to get rid of these negative emotions as how they’re labelled, was the attempt successful? Did trying to control your emotions make it even stronger, ironically? So you’re more nervous trying not to be nervous?

So why ACT (Acceptance and Commitment Therapy)? Because in ACT, we understand in life negative emotions, thoughts, experience, sensations are all just as likely to happen as the positive ones, they are all part of our life, they are what make our lives meaningful, educational and contented. So in ACT, people learn to accept them, to live with them, instead of struggling with them, challenging them, changing them, getting rid of them.