For People Who Care for People with Dementia

Telling people who they are, what they feel and think, or telling them what they have done or perceived isn’t real, right, or doesn’t matter is a form of psychological control and abuse commonly termed “gaslighting.” More extreme methods used to control captives and/or extricate information from them that attack the person’s selfhood and sense of reality – after first creating a bond, attachment, or dependence between captor and captive – are considered aspects of psychological torture.

Bob Giles at 86The person with dementia may involuntarily gaslight the person who serves as the caregiver.

(Using person-first language respects the personhood and individuality of all involved. For the sake of clarity and brevity, hereinafter, the person who offers care may be termed “caregiver” and the person who receives care is termed “person.” I define “caregiver” as a person who self-defines as a caregiver, either as a direct provider of care, a person who coordinates care, or a person who participates in care from a distance. Singular pronouns will be “they/their.”)

The person’s words and actions say, “I don’t know who you are, your every effort to communicate and connect with me is futile, and you can do nothing helpful for me. I reject your attempts to keep my behavior socially normative. You, your best efforts, your needs and wants, your mind, your heart – they have no power and are irrelevant to me. Our shared history is irrelevant to me. You, and who we are to each other, are now erased. You might as well not exist. Your perception of a reality in which you matter to me is wrong. You don’t matter to me.”

And the child may hear implied by the parent, the very source of their existence, a more global: You don’t matter.

“Gaslighting” effects from serving as a caregiver for a person with dementia can include attachment wounds and existential distress.

To limit “gaslighting” effects, a caregiver might:

Give due weight to the illness. In dementia, the brain’s deterioration causes involuntary symptoms in the form of troubling words and actions. The unknown and uneven directions and rates of deterioration may leave words and behaviors nearly random. Unresolved concerns from the past may, possibly, influence the person’s words and behaviors, but it may primarily be a malfunctioning brain, not the person, doing the speaking and acting.

Acknowledge the realities of the illness.  Although we may desperately wish otherwise, no effective cure or treatment for dementia exists. Symptoms tend to persist and worsen in spite of any and all medicinal, behavioral, and environmental interventions.

Acknowledge the realities of witnessing the person’s words and actions. The human brain has evolved to work with reality very well, much of the time. Most people, most of the time, speak and act within a predictable range. Spoken and behavioral symptoms of dementia can seem alarming, surreal, and other-worldly. Feeling disoriented and distressed are normal responses to an abnormal situation.

Acknowledge inhumanity and humanity. Witnessing the inhumanity of another’s suffering and being helpless to do anything about it feels unbearable, but staying present and refusing to allow the person to suffer alone are acts of humanity.

Separate the self from what is happening. Survivors of hardships report the same wisdom: “I am here. What is happening is there. There are not the same. I am not what is happening. I am myself.”

. . . . .

In this post, I use the general term “dementia” to refer to specific neurocognitive disorders and other disorders involving deterioration of the brain.

I serve as the primary care coordinator for my father, Robert “Bob” H. Giles, Jr., who developed symptoms of dementia at age 85. Before he lost his ability to reason and remember, he urged me to share any aspects of his story that might be helpful to others. I share with his permission and in his honor.

These are times of scarce mental health resources. Many have to serve as their own counselors. For assistance with existential distress, I have created this list of questions that may be helpful.

Serving as a caregiver for a person with dementia may, at times, feel traumatizing. These resources may also be of assistance.

Other posts of possible interest

If you live in the Blacksburg, Virginia, U.S.A. area, provide care for a person with dementia, and are interested in forming a group, please contact me. I posted this request on 10/28/21 on the Everything Blacksburg page on Facebook.

This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Self-Help Guide for Reducing Trauma Symptoms

If I were only allowed two, plain-language sentences to explain what trauma symptoms are and how to reduce them, these would be the sentences I would offer.

  1. Trauma symptoms result from the brain being overworked from being alarmed at too high of a level for too long.
  2. Reduction in trauma symptoms requires “un-alarming” the brain to a low enough level, for a long enough time, for it to restore to stable functioning.

Using one's own mind and heart as tools

I’m anticipating that people who have found this post may have already consulted sources like the National Institute for Mental Health or the National Center for PTSD. They may hypothesize that the troubling feelings, thoughts, or actions they are having might be considered symptoms of trauma-related disorders.

[One can only view official diagnostic criteria through purchase of access to the Diagnostic and Statistical Manual of Mental Disorders (DSM–5).]

One of the leading cognitive theory-based counseling protocols for trauma disorders is cognitive processing therapy (CPT). This self-help guide is founded in CPT, with additions as noted below.

Becoming one’s own therapy provider

For various reasons, including privacy and safety concerns, or lack of access and resources, people with distressing symptoms may have come to the conclusion that they need to figure out how to become their own trauma therapists.

Auspiciously, the top, evidence-based counseling protocols for reducing trauma symptoms are based in cognitive theory. A premise of cognitive theory is that individuals learn and practice skills with a mentor, then take over as their own mentors, coaches, and cognitive therapists. One of the most heroic examples of this exchange is by the women of the Congo, many of whom could neither read nor write, who worked together using CPT in 2013.

Validating the idea that trauma therapy can be effectively self-administered, according to a CPT training I attended, a self-help CPT manual is in development.

About this guide

For people in need right now, during a period of intense, global distress, whose only access to counseling for trauma may be a mobile phone, I have attempted to, in plain language, using straight text:

  1. Synthesize and distill the findings of research on what reduces trauma symptoms for most people, most of the time, most efficiently, better than other ways, and better than doing nothing.
  2. Add pandemic-urgent elements to cognitive processing therapy (CPT) from other other cognitive theory-based protocols, including cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT). These additions have been found to be helpful to clients doing trauma therapy while undergoing the stressors of lockdown and the threat of severe illness or death during the COVID-19 pandemic.
  3. Add the hard-won insights we gained from attempting to address trauma symptoms while isolated at home, from the distance of online-only counseling sessions.
  4. Add case study data, practice wisdom, and personal wisdom from clients’ and my own experiences with engaging in therapy for trauma.

Caveats

Writing plainly and simply about recovery from trauma is difficult. This guide may not be presented as systematically and thoroughly as some might need. Self-help may be insufficient. At this time, research data is insufficient to back self-help as an evidence-based treatment for trauma symptoms. For urgent or persistent trauma symptoms, contact a health care professional.

About this post

I consider this post 1) a summary of what might be helpful, and 2) a table of contents linking to previous and forthcoming, non-sequential, trauma-related posts and pages on this site. I have attempted to be as brief and concise as possible and to use as few clinical terms as possible. I will continue to update it.

Again, if at all possible, consult a qualified, licensed counselor for individualized guidance and support.

To get started

First, consider taking one or more of these online assessments to establish a baseline for your symptoms. Then continue to take them as you begin to serve as your own cognitive therapist. These scores can create tangible data by which you can track your progress and show areas of strength and challenge. Taking any assessment comes with the caveat that expert interpretation should be done by an expert.

CPT uses these assessments:

Other assessments in the public domain that might prove of interest:

  • PC-PTSD-5. Assessment and explanation here.
  • ACE Score. Assessment and explanation here.
  • If you have interest in other online assessments, these from the American Psychiatric Association are in the public domain. The Society of Clinical Psychology maintains a list of assessments in the public domain. Again, consult an expert for expert evaluation.

Next, familiarize yourself with stressor-related and trauma disorders and what treats them. Consider one, some, or all of these.

Then, read Becoming One’s Own Cognitive Therapist.

Consider taking online training in CPT to learn CPT first-hand and to possibly pass the protocol onto others in need. Several trainings are listed on our main CPT page and are free or low-cost.

Now that we know the central role alarm plays in both developing and reducing trauma symptoms, let’s go about un-alarming our brains.

Self-administering CPT

Option 1: Comprehensive. Uses the CPT therapists’ manual.

CPT is structured to consist of 12 sessions. The first 7 sessions are considered fundamental and the last 5 offer deeper insights. Some people experience noteworthy symptom reduction in a few sessions – termed “early responders” – and complete the protocol in fewer than 12 sessions.

Although Cognitive Processing Therapy for PTSD: A Comprehensive Manual (hereafter referred to as “CPT manual”) is intended for therapists, portions are highly readable and can be used to self-administer the protocol. Sections noted below can be found by turning pages in the print version or scrolling through the electronic version.

  1. Read “A Biological Model of PTSD and CPT,” pages 10-13.
  2. Read “Describing Cognitive Theory,” pages 89-93.
  3. Follow the directions in this CPT session outline.

Beginning with Chapter 5, which introduces Session 1, and subsequent chapters:

  1. Read the goals for each session.
  2. Read the sections in quotations. These are sample scripts for therapists which conveniently and succinctly summarize the central concepts of the session.
  3. Read the dialogues between CLIENT and THERAPIST which provide examples of the crucial concepts highlighted in that session.
  4. Study the handouts, usually collected at the end of each chapter.
  5. Complete the “Practice Assignment after Session ___ of CPT,” to practice specific cognitive skills.
  6. Retake assessments to track progress.

Consider using these posts to orient yourself to counseling for trauma, or to review concepts you have covered.

Option 2: Streamlined. 

    1. Study the CPT session outline.
    2. Complete the components requested in the CPT session outline.
    3. Read and reread posts in the bulleted list above. They are densely written, each word chosen to convey as much information as possible without straying into simplicity or error. Do the exercises to which they link.
    4. Use this Expanded ABC Worksheet.
    5. Retake assessments to track progress.
    6. If you find this method inadequate, consider using the comprehensive option.

Option 3: Fast track.

Trauma symptoms are caused by the brain being too alarmed for too long to function stably. People with trauma symptoms frequently describe feeling as if their “brains are on fire.” This makes sense. Although an over-simplification, when people have trauma disorders, the emotion centers of the brain overwhelm the cognitive centers.

We don’t have mechanical ways of restoring cognitive centers. Medications for trauma symptoms are of limited assistance. To restore their brains to stable functioning and, thus, reduce trauma symptoms, people have to use cognitive skills – their own hearts and minds as tools – to ease the brain’s emotion centers and activate cognitive centers.

Since cognitive theory posits that thoughts cause feelings, logically, then, thoughts that cause alarm are the subject of interest. Surprisingly, beliefs about the way people should be, others should be, and the way the world should work unconsciously cause alarm. When people or situations aren’t as they’re believed they should be, this is experienced as a discordant, existential threat.

Since the brain evolved to handle reality as it is, approaching, acknowledging, and accepting reality and the human condition as they are – complex and dynamic, however, painful and sorrowful they might be – begins to restore the brain to stability.

Here’s a summary of the inner dialogue of a person using cognitive skills to ease emotion centers and activate cognitive centers. Most terms used are in the glossary and in other posts on this site.

“I am aware of an intense inner state. Let me take back my consciousness. What am I feeling? Which are my primary feelings and which are my secondary feelings? Let me feel my natural, human, primary feelings. My brain is designed to handle them. They will come and they will go. Now, what are my secondary feelings, caused by thoughts? What thoughts am I thinking to cause these feelings? Of those thoughts, which are beliefs? Which are facts? Let me follow the facts. Based on the facts, and my own values and priorities, what would be the most realistic and helpful thing to say or do next – or not say or not do?”

Use that inner dialogue over and over again. Retake assessments. Consult yourself as your own cognitive therapist. If your self-help efforts are not producing desired results, it would be realistic and helpful to consult experts who may be of assistance.

Finally

I share openly that I developed trauma symptoms after experiences of school and community violence in 2007. I worked with two psychologists using cognitive theory-based protocols, achieved remission from trauma symptoms, and became a rostered provider of cognitive processing therapy in 2019. In 2021, I experienced re-emergence of some of those symptoms, including involuntary ones. I consulted a psychologist, reviewed my training, wrote about the re-emergence of trauma symptoms here, and wrote this, the index page of a guide to help people reduce trauma symptoms.

As Marsha Linehan, Ph.D., puts it in her DBT Skills Training Manual, “People may not have caused all their own problems, but they have to solve them anyway.” I am sorry for you and for me that we have experienced these hardships. AND. We can help ourselves continue on, living as richly and consciously as we can in the time we have.

Given the intense distress that trauma symptoms can cause, in order to reduce people’s suffering, urgency is merited. I’ve imagined myself inside a train at the window. A distressed person on the platform, at the last minute, calls out to me, “I have trauma symptoms! How can I help myself?!” I’m able to answer with only a few sentences as the train pulls away. What would I say?

“You are not what happened to you! And symptoms aren’t your fault! They’re a brain thing! You’ve got to un-alarm your brain! Thoughts cause feelings! Look at the content of your thoughts. Be humane and merciful. Do not judge. Do NOT impose rules. Follow facts! Be kind!”

CPT resources

Specific posts on this site that may be of interest (also linked to above)

Views expressed are the author’s own. This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

A Formula for Relational Effectiveness

Consider the following formulation for creating new possibilities for effective relationships, particularly partner relationships.

One person and another person. Each person is a separate, self-aware entity, a whole self, comprised of a true self, a personal history, and beliefs held about relationships taught by family, culture, and the media.

Each person is responsible for identifying and stewarding their own needs, wants, preferences, strengths, values, and priorities and discovering and discarding unhelpful beliefs about relationships.

The relationship. Each person contributes a portion of his/her/their whole self – ideally components of the true self – to mutually co-create a third entity, the relationship. Instead of attempting to shape or transform (or force) oneself or the other to meld personhoods into oneness, the contributions of each work together in synergy to create a novel, separate relationship that enriches each and both.

(Pronoun for both singular and plural, used hereinafter, is they/them.)

Inputs. Each person attempts to add to the relationship what helps it, not hurts it. Each person self-monitors what they contribute to the relationship.

Conflict. Conflict naturally arises from difference. To both protect and foster the co-created third entity – the relationship – each person maintains awareness of self, other, and the relationship, and speaks up when something is awry.

Negotiation. The purpose of negotiation is to – in mutual, well-intentioned synergy – decide what inputs each person can add or remove to protect and foster the relationship. Each person focuses on themselves and their experience of the relationship, rather than on fault-finding or blaming. (Each person’s insufficient self-awareness or relationship-awareness can often be sources of unhelpful inputs to the relationship.) Rather than “working on the relationship,” each person works to become aware of their own helpful and unhelpful inputs to the relationship.

In a relationship where both partners seek and practice self-awareness, sentences using “I” would often outnumber sentences using “you.”

Sources of conflict

Imposition of unconscious, unexamined beliefs about how self, others, and relationships are or should be is a primary source of conflict in relationships. Beliefs can be held so strongly that they are perceived as facts.

(The “power of love” to change people is a common belief in many cultures. Another one is, “They should know what I’m feeling or thinking without me having to tell them.” If we do the numbers on the human condition, particularly on the human brain, we pretty much don’t stand a chance. If we don’t tell them, the odds are enormous that they don’t know.)

Attempts to control or change the other person – to attempt to make them 1) do what is desired, or 2) not do what activates anxiety or fears – is a source of conflict in relationships.

Expectations – non-negotiated, unspoken, and/or mismatched – about the frequency, duration, and method of contact are another source of conflict in relationships.

Unilateral decision-making is a leading cause of relationship discord. Unilateral decision-making is the act of making a decision – the results of which might impact the other person – without, at minimum, prior notice, or, optimally, prior negotiation to increase probabilities of maximizing benefits and minimizing costs for both parties and the relationship.

Unilateral decision-making by one person often activates intense feelings and either-or thinking in the other person. Although perhaps not intended, statements such as these may be implied or perceived:

  • “My priorities are more important than your priorities.”
  • If I “didn’t think to tell you,” “forgot” to tell you, ghosted you, or no-showed: “You are forgettable and non-important.”
  • If I was “afraid to tell you”: “I avoided telling you the truth because my concern for my feeling of fear weighs more heavily than my concern for any troubled feelings you might have.”
  • “You can count on me as long as what you want from me is what I want to do.”
  • “I care for you less than you care for me.”
  • “I have more power in this relationship than you do.”
  • “Although we have a spoken or unspoken contract, it’s okay for me to breach it and not say or do as I promised because my needs and wants come first.”
  • “It is all about me.”

What the other person may feel, think, and do as a result of learning of, or experiencing the making of a unilateral decision:

  • Primary feelings: sad, afraid, mad, surprised
  • Secondary feelings: feeling hurt, overwhelmed, disoriented, discounted, de-identified, de-prioritized, devalued, betrayed, used/misused, excluded, deprived, full of rage, resentful, unsafe, doubtful, wary, humiliated, lonely
  • Actions: withdrawing, withholding, and shutting down; accusing and criticizing; moving from active, to passive, to indifferent; contemplating exiting the relationship and/or enduring it for reasons other than regard.
  • (Primary and secondary feelings are defined in this glossary.)

Why one person may make a unilateral decision without informing the other

  • The subject is within the person’s rights to make a solo decision.
  • The subject was new to both parties’ awareness and had not been discussed or negotiated.
  • In a relationship where people are attempting to change or control the other person – rather than mutually negotiate a relationship – the subject may have been avoided to avoid the other person’s objections or counter-control efforts.
  • Deficits in self-awareness and relationship-awareness, unacknowledged disinterest, or intention to hurt may result in unilateral decision-making.

Caveat: Regardless of the reason, unilateral decision-making can be a dealbreaker for relationships. Some relationship thinkers posit the existence of a relationship “bank account.” A single withdrawal that results in a significant sense of unsafety, distrust, or non-mutual power-sharing may require manifold deposits to replace.

To address conflict

  • Approach reality and acknowledge the data.
  • Are both parties able to agree on what constitutes data, facts, and reality? Is there an attempt to convince, contest, or defend? Since a relationship is based on mutual understanding, further progress may be unlikely.
  • For pain caused by insensitivity, apologize.
  • Examine intentions. Does each person have the best intentions for the other, regardless of whether or not the relationship exists? What is the purpose of each person’s engagement in the relationship?
  • Examine outcomes. Is synergy occurring? Does each person, for the most part, experience their personhoods and lives enriched by engagement in the relationship?
  • Attempt to mutually negotiate next steps.

Of possible interest

In addition to other sources, the above text is informed by cognitive theory, the concept of dialectical synergy born of “Opposites can both be true,” a concept central to dialectical behavior therapy, invented by Marsha Linehan, Ph.D., work by the Gottmans, and relational self-awareness theory, formulated by Alexandra Solomon, Ph.D. The accompanying hand-drawn diagram is adapted from Alexandra Solomon’s “My Stuff + Your Stuff = Our Stuff” slide from her training Loving Bravely: Helping Clients Who are Single, Dating, & Single-Again.

This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Addressing the Return of Trauma Symptoms

Colleagues, clients, and I are talking about the return of trauma symptoms in people who have achieved remission from post-traumatic stress disorder (PTSD). It’s possible that pandemic conditions have strained brain resources that kept people in remission. Beyond pandemic languishing, to describe this current push-pull of stressors, Amy Cuddy, Ph.D., and other thinkers are using the term pandemic flux syndrome. Counselors and clients, together, are working on how to return to remission from trauma symptoms during these unprecedented times.

Let’s review what we know about trauma, trauma symptoms, and how to reduce them.

(A comprehensive explanation of trauma and its treatment are beyond the scope of this post. Information from the National Institute for Mental Health and National Center for PTSD may be helpful.)

At essence, the cause of trauma symptoms is the brain being alarmed too high, for too long, for it to recover its stable functioning.

Post-traumatic alarm is caused by:

  1. novel experiences of danger, threat, and shock,
  2. residual physiological and psychological effects from having experienced the original trauma(s),
  3. involuntary trauma symptoms,
  4. lack of comfort and help with thinking, and
  5. ways of thinking that perpetuate alarm.

At essence, to reduce trauma symptoms, a person has to “un-alarm” their brain for long enough for the brain to recover stable functioning.

In the list of the causes of alarm, although #1 is part of the human condition, and #2 is permanent, #3, symptoms, can dissipate if a person can help themselves with #4 and #5 as their own cognitive therapist.

Unfortunately, this process doesn’t:

  • make “un-happen” what happened.
  • result in instantaneous relief from an act of determination or will.
  • remove feelings, including those judged as “negative.”
  • disarm normal human brain functioning. Remembering – both consciously and involuntarily – and feeling activated will continue to happen.

Beginning with #4, after offering kindness and comfort to oneself, one heads directly for #5, ways of thinking.

Here are some initial questions to ask oneself:

1. Although I may not want this to be true and I may be somewhat numbed to it, what is going on in my life that logically and understandably might be alarming me? This could be one thing or a list of things. Although stressors related to the pandemic may be on my list, let me go deeper. What else might be alarming me?

2. Thinking “This shouldn’t be this way,” can alarm the brain. About what, even in the smallest way, am I thinking, “This shouldn’t be like this” or “This shouldn’t have happened”?

3. Thinking “This is too much for me,” can alarm the brain. Am I thinking, perhaps about some things at some times, “This is too much for me”? About what?

4. Thinking “I should be or do _____” or “I shouldn’t be or do ______” can alarm the brain. About what am I thinking “I should” or “I shouldn’t” about myself or my efforts? About what am I thinking “They should” or “They shouldn’t” about others and their actions?

5. Feeling upset or outraged at others can alarm the brain. Sometimes outrage at injustice is merited. Sometimes, I can rage at others or despair over myself or others as an outpouring of an inner sense of powerlessness, helplessness, and lack of control. Am I in danger and need to extricate myself? If I am not in danger, about what am I feeling a lack of power and control?

6. The brain knows “tough love” is an alarming oxymoron. Am I using “tough love” on myself? About what am I criticizing and judging myself? By what criteria am I measuring and evaluating myself and coming up short? Are these criteria realistic and helpful, aligned with my values and priorities, or are they cruel rules?

7. What facts and realities about myself, others, the human condition, and the way the world works am I avoiding? What do I need to approach, see as it is, acknowledge and/or accept, address with my cognitive skills, and, thus, help “un-alarm” my brain and ease my distress?

Of the 100 billion humans estimated to have ever lived, we can’t know what portion of them experienced trauma, or developed trauma symptoms. Over half of U.S. women and 60% of U.S. men have experienced at least one traumatic event in their lives. In my estimation, those who attempt to reverse the very brain changes that result in trauma symptoms are no less than heroic.

. . . . .

The content of this post is informed by cognitive behavior therapy (CBT), dialectical behavior therapy (DBT), cognitive processing therapy (CPT), acceptance and commitment therapy (ACT), positive psychology, and other therapeutic modalities.

Image: iStock

This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Becoming One’s Own Cognitive Therapist

A fundamental premise of cognitive theory-based counseling protocols is that, once people learn cognitive skills, they can take over as their own cognitive therapists.

What does this mean exactly?

A cognitive therapist uses the research-backed elements of cognitive theory to help a person acquire cognitive skills.

“Cognitive theories are characterized by their focus on the idea that how and what people think leads to the arousal of emotions and that certain thoughts and beliefs lead to disturbed emotions and behaviors and others lead to healthy emotions and adaptive behavior.”
DiGiuseppe, et al., 2016

A person with cognitive skills, in the context of self-kindness, becomes aware of having felt, thought, spoken, or acted automatically, regains consciousness, deliberately frees themselves from getting boxed in by beliefs about what one should or shouldn’t be and do in favor of making principle-based decisions, sees reality as it is, and makes helpful, criteria-based choices about what to say or do next – or not say or not do.

Boxed in by beliefs

“Take back your consciousness.”

At essence, a person with cognitive skills can become aware of when they need to say to themselves, “Take back your consciousness.”

People who seek counseling often realize that ways of feeling, thinking, speaking, acting, studying, working, and/or relating are interfering with their own intentions for themselves, and with their ability to relate effectively with themselves, partners, children, family members, instructors, co-workers, and/or community members.

Very often, these ways are unconscious and automatic, born of temperament, brain traits (such as sensory sensitivity or attention variations), childhood or later trauma, family of origin challenges, and learnings from families, communities, education, culture, nationhood, and the media.

A conscious self-embrace

Use of a set of research-informed counseling protocols – categorized as applied “cognitive theory” – can help people use awareness of their thoughts and feelings to identify these automatic ways, begin to see facts and realities as they are – however unwished-for they might be – assess probabilities, derive strategies, and make conscious choices based on their needs, wants, strengths, preferences, values, and priorities.

My work with clients is primarily informed by these cognitive theory-based counseling protocols: cognitive behavior therapy (CBT), dialectical behavior therapy (DBT), and cognitive processing therapy (CPT).

“Cognitive” can be considered a cold term, but cognitive-based counseling is anything but. The entirety of one’s feelings, thoughts, and experiences are courageously and deliberately honored and addressed. People map out what occurs, what’s in their hearts and on their minds, then use all that data to decide what would be the most realistic, helpful action to take. This meticulous examining is nothing short of heroic. Kindness, mercy, and bravery reign.

“Getting cognitive” also does not mean becoming robotic. One’s full humanity is seen, known, and appreciated. Reality is approached, not avoided. Reality is complex and dynamic; reality delivers unexpected shocks and sucker punches. Cognitive skills can’t undo what’s done, or make people “un-feel,” “un-think,” or “un-experience.” What they do is give people the power to help themselves through experience of all kinds, including hardships.

Self-kindness becomes direct rather than indirect. Rather than “giving oneself a break,” granting an indulgence, or engaging in a distraction, people can pause, use their attention, become deeply aware of what would be truly kind, and do that. With practice, self-kindness can feel moving, ecstatic, powerful, and peaceful, all at the same time.

Why become one’s own cognitive therapist and gain cognitive skills?

Even if only partial consciousness exists through ever-present stressors at home or work, immediately after shock or loss, after brutality or injury, or through congenital brain traits, accompanied by one’s consciousness, one can co-travel kindly and effectively with one’s experiences: inner and outer; past, present, future; kind or cruel; expected or unanticipated; desired or undesired.

In particular, a person can take back consciousness:

  • from despair;
  • from naturally and understandably feeling powerless, helpless, hopeless, victimized, overwhelmed, and in chaos by the facts of one’s existence: past traumas, past losses, the pandemic, memories, nightmares, symptoms, nearly automatic substance use, emotional and physical pain, and current incidents and situations;
  • from replaying a past event in hopes of figuring out what might have made it go differently;
  • from alarming and re-alarming one’s brain from replaying a past event;
  • from taking troubling experiences in short-term/working memory into deeper, long-term memory through repetition (a “flashcard effect”);
  • from attempting to anticipate, plan for, and script future events;
  • after having developed an intense inner state to regain cognitive functioning;
  • from learned actions intended to relieve intense inner states, such as use, overuse, or ill-use of substances – food, caffeine, nicotine, alcohol, marijuana, prescribed and non-prescribed drugs – eating unintended foods and eating more than intended; purging; words and actions born of impulse, anger, and rage; many others.
  • after involuntary occurrence of intrusive memories, thoughts, and nightmares;
  • from attention going “there” instead of “here,” i.e. where it was intended to go and stay;
  • from symptoms and traits of disorders such as trauma and stress disorders, obsessive-compulsive disorder, attention deficit disorder, mood disorders, personality disorders, autism spectrum, and others.

Why take back one’s consciousness?

Outcomes. Simply put, people want to feel better and to do better. Based on decades of research, cognitive therapies help many people feel better and do better, much of the time, better than other therapies, and better than doing nothing.

Once one has one’s consciousness back, what does one do with it?

Co-travel. Co-travel with what is happening. Keep the self and one’s identity separate from one’s inner and/or outer experience. Operate from within one’s consciousness. State, for example, “I feel fear” rather than “I am afraid.”

Consider precise, person-centered language. Note the differences between “I am a person in remission from addiction” and “I am an addict.” Compare “I am a person who, at times, experiences anxiety” to “My anxiety is bothering me.”

How does one take back one’s consciousness?

Consider this sequence:

  1. Become aware of having a sense that something is a bit “off” and say to oneself, “Take back your consciousness.”
  2. Access the portion of one’s consciousness in which resides a) one’s inner wisdom and true self, b) awareness of this knowledge: one’s needs, wants, strengths, preferences, values, and priorities, and c) one’s cognitive skills.
  3. Engage self-kindness and banish belief-based self-judgment and self-criticism.
  4. Become aware of what one is feeling.
  5. Sort feelings into primary* and secondary** feelings.
  6. Kindly and humanely help oneself with primary feelings.
  7. Use secondary feelings as data about one’s thoughts. Ask, “What thought caused that feeling?”
  8. Identify thoughts as beliefs or facts.
  9. Shift one’s attention to thoughts about facts and reality.
  10. Comfort oneself if realities are painful or fervently wished otherwise.
  11. Using the criteria of one’s self-knowledge, values, and priorities for direction, imagine options, assess probabilities, then choose.
  12. Derive implementation strategies.
  13. Appreciate, acknowledge, and accept: “This is the best I can I think of with what I know at this time and with the resources I have.”
  14. Based on the above criteria, say or do – or don’t say and don’t do.
  15. Take back one’s consciousness again and again if any one of these occurs: second-guessing, self-criticism, self-judgment, repetitive thoughts (“noodling,” ruminating, listing), replaying past troubles, or anticipating future dire consequences.

Always, always practice self-kindness.

We are human, humans have extents and limits, reality is complex, and we each have such a short time on the planet to work things out. Kindness is merited.

. . . . .

*Primary feelings are natural feelings that go along with being human and happen automatically without thought: mad, sad, glad, afraid, surprised, disgusted, alarmed (includes fight-flight-freeze response).

**Secondary feelings happen as a result of thoughts – often thoughts that are opinions, beliefs, or rules – that cause feelings of shame, guilt, humiliation, self-blame, mistaken other-blame, regret, rage, dread, panic, despair, nostalgia, jealousy, righteousness, vengeance, and “ideations,” i.e. intrusive thoughts or fantasies of harm to self or others. Secondary feelings that result from thoughts cause suffering through 1) escalating natural feelings, 2) causing painful feelings, 3) creating a sense of “no escape,” which can result in feelings of rage, helplessness, and hopelessness, 4) increased reactivity vs. conscious choice, and 5) creating troubled interactions with others.

Photo images: iStock

This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.