Thoughts, Selective Attention and Confirmation Bias

Lately, in session, I’ve been talking with numerous clients about whether or not thoughts define us, as well as various biases humans are susceptible to that often keep us stuck cognitively. I thought it could be useful to address them both today. 

Do our thoughts define us? 

I’ve been quite open about the fact I have obsessive compulsive disorder. Simply put, one experiences obsessions (intrusive thoughts) and compulsions (behaviours to manage the obsessions). Thoughts of killing my family would flood my mind. At the time, I had no idea what was happening, or that it was a mental illness. I thought because I was experiencing these thoughts, they must say something about who I am. I thought I was a horrible human being, a daughter who should never be trusted, evil, and so on. 

It took a long time in therapy, to get to the realization that my thoughts didn’t have to define me. That thoughts could just be thoughts. That I didn’t have to put a “value” on them as either good or bad. My being didn’t have to be in question just because something popped into my mind. Every thought did not need to be an internalization of who I was or am. 

Capability also doesn’t define one’s worth or value. I wanted to believe that I could never be capable of hurting/killing the one’s I love (or other humans around me). I used to think that because I “thought” it, this somehow made me more capable. The truth is, we all have the ability to cause harm. Capability, just like thoughts, however does not automatically mean one will do it or that they want to do it. 

Now, let’s just say, I have thoughts about myself that I don’t like. Perhaps, it’s a worldview or core belief. It is possible to change the way one thinks. Neuroplasticity is real! It’s helpful to take stalk of what drives our behaviour as well as how we think/feel about ourselves and others. With practice, we can go from changing negative self-worth into positive self-worth. From not believing recovery is possible, to having hope that it is and so on. 

Okay, so, let’s agree that thoughts don’t have to define us. That one can let them come and go (I know this is easy to say. Practice is needed.) without having a value attached to them. The next part of this blog will explore are ability to take information in and the biases that shape our perceptions.

There are many different biases and cognitive theories that shape how we take in informaiton. I’m going to focus on two: selective attention and confirmation bias. 

Selective attention occurs all the time. There’s a lot of information/stimuli out there, that we can’t take it all in at once. So, we have to filter the information, and usually, it’s the most relevant information. 

Try this exercise. 

https://www.youtube.com/watch?v=vJG698U2Mvo

The potential problem with selective attention is that we might miss some really important information (or gorillas!) that may be beneficial in moving us forward in recovery.

Confirmation bias results when we only pay attention to information/stimuli that confirms what you already think. An example would be if you have an eating disorder, and don’t think you’re sick. You might only pay attention to, and take in, the information that confirms or is consistent with this belief. It does not mean that there is not information out there that challenges this belief (ie: medical complications, social limitation, anxieties around food/weight/body image, ED behaviours, etc), but you aren’t giving it much thought/weight as it challenges your belief. 

How does talking about bias and selective attention relate to the piece about thoughts defining who we are? If we don’t think highly of ourselves, we will continue to selectively pay attention to information and stimulus that confirms this belief, despite there being a plethora of information to the contrary. If we don’t think we can recovery, we will constantly take in information that keeps us stuck. If you think no one loves you, you might look past the positive relationships in your life.

So, what to do? As always, I’d encourage you do connect with a therapist in trying to figure some of this out. Experiment with being mindful of what goes on in your day, as well as your thoughts and reactions. Take stalk of what people are saying and how many people are saying it. Do you react more to one piece of information than another? When someone gives you a compliment, instead of brushing it off, take a second to hear it and recognize that your need to discount it might be you falling into confirmation bias. In some ways, this is what CBT thought records, or DBT’s Wise Mind, is trying to get you to do. To see another perspective. Experiment with opening the door a little. There just might be another angle to see. 

The 'Right' Decision

I remember being paralyzed as a teen/young adult by trying to figure out the “right” decision, “so much so I’d be in tears. I’d repeat to myself, “I don’t know what to do! I don’t know what to do!” Most decisions felt detrimental to my future success or consequently, failure. My faith also played into this process. Doing “God’s will” was so important to me. If I wasn’t 100% certain that choosing “A” versus “B” was God’s will, I could’t make the choice. 

Certainty is a funny thing. The more and more I grow, the more and more I am tolerant and accepting of uncertainty. It doesn’t bother me as it once did. I think there are many factors that play into this. I embrace the fact that I don’t know everything. That, I could, and will be “wrong” from time to time. Me being certain, on some level, implies I have all the information. So, when I was worrying myself sick about choosing“A”  versus “B” in my teens/twenties, I thought I knew everything that I needed to. Information is always changing and growing. Iremember sitting in therapy one time, getting so upset at the concept that how we were doing therapy may not be how we’d be doing it in 10-15 years. That perhaps, a more effective way could emerge. Of course ongoing and future research will reveal more as it evolves with time. Can you imagine if it didn’t? 

Uncertainty made me doubt. Not only myself, but the people and life processes around me. Does doubt have to play into the equation though? Could it be possible to accept uncertainty as just uncertainty, taking “right” and “wrong” out of the equation? I’m not saying throw all caution into the wind (although, that’s not always a negative thing), making impulsive decisions. Still take into account logic and rational, balancing the emotion, when decision making. It’s really hard to move forward if we never take the first step. A lot of life is what you make it of. There will aways be things that come our way that is out of our control. Just remember, in those experiences, we usually have a measure of control with how we react to it. 

Experiment a little this week. When you catch yourself in those moments of “I don’t know what to do”, take a step back, balance the emotion with some rational (perhaps this involves talking with a therapist or trusted confident), and then take a step. Whatever happens, there will be more steps to take after that. Not everything in life is determined by that one decision. Happy decison making!

Body-Image Exercise Through Art

Developing healthy body image is a bit of a concoction… 1 part acceptance, 2 parts forgiveness, 10 parts self-compassion and so on.

To date, I have not met anyone who has never had periods of poor body image. I’m not saying they don’t exist, I just think it’s a human thing to experience at some point in life. And, unfortunately, for many, this experience is more than just a “period” in their life, versus what they have always known or experience day to day.

Often, we get caught up in what our body looks like… or perhaps, what it doesn't look like. The negative voices that dominate our thoughts telling us: I’m too bald, I’m not bald enough. I’m too short, I’m too tall. I’m too fat, skinny, wrinkly, pimply, and so on and so on. It’s exhausting. So, for today, I want to shift away from what our bodies look like and focus on what they do for us. Thanks to Eve Tesluk, a professional art therapist in Guelph, for introducing me to this exercise to do with my clients. 

Thanks to my colleague Megan Callon for supplying me with the drawn figure you will see below to demonstrate an exercise I often do with my clients. As always, please note this drawing is just one of the many different shapes, sizes and forms bodies come in and is not meant to represent an 'ideal' (remember, health at every size!!). Also, the individual described below is fictitious.

Here’s a picture of what you will need.

I get clients to think about what they like to do and how their body experiences these things. Through colours and symbols, I get them to draw/colour where on/in their bodies they experience these activities. By doing so, we are moving away from appearance, and more on its function.

This individual below, appreciates their feet as it allows them to skate, their fingernails as they often get painted funky colours and their hair that allows them to express themselves in various colours and lengths. They enjoy watching movies, smelling nature and feeling the warmth of the sun on their shoulders and body. They appreciate their fingers and toes that help give them balance as well as to wear rings.They appreciate their ears and the ability to listen to sounds, especially laughing or the deep quiet the night can bring. When they feel empowered, they see it in orange, both in their mind and their heart. They enjoy their tongue/mouth as it enables them to eat ice cream.

They acknowledge the struggle they have with their thighs and stomach, however know without the strength that comes from these areas, they would be unable to do so much of what they love. They symbolized this to remind them these areas are their powerhouse that gets them through their day. 

Often, the drawer will neglect symbolizing or colouring certain areas of their figure. More times than not, it is these areas that they need help with reframing or finding its purpose. Everyone will have a different reason for why they struggle with a particular area. Some feel betrayed by their body. Sometimes it’s finding the little things, like the fact skin helps contain our bits, blood and guts, protecting us from the world, that helps start developing a different narrative. It’s function doesn’t have to be mind blowing. It just has to be something that helps reframe how they think or see their body. Perhaps, it’s being thankful that one of their two ears can hear, or one of their two eyes doesn’t cause them pain.

And as always, developing a healthier or more tolerable relationship with one's body is a process. This exercise is just another way of exploring a different aspect of what are bodies can do, and in turn, part of who we are. Give it a try and talk it over with your therapist or trusted support.  As always, practice compassion and think outside the box society likes to put us in! And, if you liked processing thoughts, emotions and issues through art, check out Eve Tesluk in Guelph, ON, or another professional art therapists in your area. 

I Just Want to Sleep!

I don’t know about you, but when I don’t get enough sleep, I start to crumble. I am more sensitive, unmotivated, tired, and lose the ability to hold a level of rationality needed to balance myself emotionally. My reserves are tapped and I need those reserves!

As a kid growing up, sleep overs were awesome! It was fun to stay up late playing Nintendo, watching movies or reenacting scenes from Ninja Turtles. I was no treat to be around the next day if an early morning was in store or chores awaited upon getting home. I’m sure the gerbil cages could have handled another day… or week… before getting cleaned (I mean, even on a rested day, who wants to handle rodent poop!).

Enough rambling about 4 legged creatures or pizza eating turtles who live in sewers… Let’s talk about sleep hygiene. At some point in my early twenties, I realized how much I hated going to church, ringette or work half dead due to a late night shenanigans.  It wasn’t worth it. Not the most popular of choices back then, but now I try as much as I can to protect my sleep (for everyone’s sake, but mostly mine!).  I often hear clients talk about their lack of sleep. And, sometimes, it is related to their illness. Regardless of the reason, we could all benefit from practicing the following:

1)      Start settling down an hour before you want to be asleep. If you know you want to be asleep by 11pm (let’s say), around 10pm, go pee, start brushing your teeth, wash your face, put your pj’s on, go pee again and hop into bed.

2)      Get up after 15 minutes.  If you’ve been tossing and turning for 15 minutes after trying to fall asleep, get up out of bed and return 15 minutes later. This can help reset your brain that it is sleep time.

3)      Calm those thoughts with mindfulness. It’s frustrating when you’re trying to fall asleep and all you can think about is that history paper you still have to finish or that you aren't asleep yet. Take a moment and think about what you see (nothing because my eyes are shut), hear (light traffic outside, breathing), taste (good old Colgate), feel (the warm blankets) and smell (stale bedroom air). This will help bring your attention to the present instead of that battle of 1812. You can also think of your calm place discussed in previous posts. Maybe you’re in a old forest, in the spring time, with lovely little forest dwellers scampering around your feet. You hear the babbling brook nearby. It’s warm, yet cool from the shade. There are definitely NO mosquitoes or black flies. You can use these skills if you wake up in the middle of the night as well.

4)      See’ya later screens!  The lights from T.V.s or phones can be disruptive to falling or staying asleep. The brightness triggers your brain into thinking it’s time to be up and awake, versus settling to sleep. Put them away and try set your phone to 'do not disturb' to avoid 3am Tweets from your night owl friends (who will be grouchy in the morning from a lack of sleep).

5)      Avoid stimulants. Caffeine, working out, reading/listening/watching captivating mysteries/murders and talking to aunt Ida who drives you up a wall, aren’t conducive in helping you fall asleep. Try finding soothing activities to do at night, like lighting a candle or listening to relaxing music (pick Enya versus Marilyn Manson, regardless of how beautiful the people are)..

6)        Have a safety object on hand. Specifically for those who have trauma or nightmares and wake up distressed or in a panic, try designating a safety/calm item in your room. Maybe it’s a blanket, stuffed animal or clock. Having a designated object to look at when you wake up from a panic attacked/nightmare can assist in shifting your focus from distress to that of calmness. Remind yourself before going to bed that if you wake up in the middle of the night feeling panicked, with a racing heart beat and quick shallow breathing, looking at object “X” will remind you that you are okay and that it was just a dream/memory. Then, focus on your breathing and mindfulness skills and go back to sleep.

7)      Temperature, noise and light. Dark, quiet and cold rooms are best for sleeping conditions. Some people prefer to have white noise if silence is unsettling.

8)      Use your bedroom for sex and sleep only.  Condition your mind/body to know your bedroom is for calming or sexual activities only. Take the TV and studying to the other room. I know this can be challenging if you are living in residence or have siblings/children, but the more you can separate these activities from sleep/sex, the better.

Medication is sometimes needed to assist with falling/staying asleep. Always talk with your doctor before going on any type of medication/supplement for sleep. The above skills are always worth learning. Knowing you have resources in your back pajama pocket may bring the peace of mind you just might (yawn)….. need in order to….(yawn)…. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

The Freedom of Radical Acceptance

Radical acceptance is a skill found within DBT (Dialectical Behaviour Therapy). It helps one in becoming more mindful as well as how to tolerating distress. A tough skill to master, but ever so freeing the more it takes a hold in one’s life. Radical acceptance is learning to see a situation for what it is, and not judge it. To look back and acknowledge all the steps, decisions and explanations as to why you are where you are in this moment. Common phrases include, “it is what it is”, “I’ll know when I know” or “I’ll worry when I have something to worry about”.

Let me paint you a few examples:

A few years ago, I took part in an international ringette tournament in Europe and Scandinavia. I was travelling with close to 40-50 other teammates, coaches and parents. We got off the plan to find out that the bus that was supposed to transport us and all our luggage and equipment was too small. A combination of people being tired and competing personalities broke out in trying to herd everyone on the bus and arrange the luggage. I grabbed a seat, sat back and observed everything that was occurring, as were some others. There was a mash up of anger, annoyance and frustration, as suggestions as to how they thought the problem could get fixed swirled in and around the bus. Comments like, “why doesn’t the company just send another bus, how unprofessional”, “maybe if “X” just sat down instead of trying to help, we’d actually get going”, or ‘“Y”’ doesn’t know what they’re talking. This is so ridiculous.” Calmness ensued when I finally realized, “it is what it is, there’s nothing I can do or say in this situation to make it any better. Instead of getting worked up about it, I’ll just accept the fact they’re sorting it out regardless of my opinions about it. We’ll start moving when we start moving”.  Of course I wanted to get to our hotel room and go to sleep. Of course I didn’t want the situation to be handled the way it was handled. Of course I wished the bus had just been big enough for us all to fit right from the beginning. However, this wasn’t the case. It simply was what it was, and I didn’t have to be out of sorts because of it.

Here’s another example. Earlier this year, I was driving back on the 401 to Guelph. My horseback riding lesson ran late, and there was traffic. I was getting worked up and anxious about the very real possibility I might be late for work. I was blaming myself, my lesson, the traffic, and on and on. Then… BAM… I caught myself and remembered radical acceptance. I tried to understand all the factors that occurred that resulted in the position I was in.

-          I was late in getting to the barn, meaning the start and end of my lesson might have                  been pushed back as well

-          we were jumping and cantering  in the lesson and my horse got sweaty

-          he hadn’t been shaved recently, so was extra hot

-          I had to walk the horse around the barn numerous times to cool off before I brushed                  him, put his coat on and put him out to the field. Normally, a brush would have been                  sufficient for him to dry and cool off before putting his coat on.

-          construction was on the 401 resulting in backed up cars

I couldn’t deny any of the above. It was what it was. Worrying about being late, or smelling like horse, was not going to somehow stop time and fix everything. It was a wasted effort. I don’t like being late for clients. I don’t like being stuck in traffic. And yet,  it was what it was.

A few years a ago, I struggled with some mental health issues that I simply did not want to accept. My unacceptance of the reality that this was indeed happening, only exasperated my symptoms.  I was struggling with what I was struggling, and by accepting this, I had one less thing to fight against… myself.

Using this skill can help reduce anxiety and create space for opportunities to address situations differently. If we’re so caught up in the thing we don’t want to accept, we rob ourselves of navigating these situations in a less distressing manner. Just because we don’t want to be struggling with mental health issues or aspects of recovery doesn’t mean we won’t. Sure, change the things you can change, and tolerate the things that in this moment you can’t, or ever will.

Give it a try! After all, we can’t control or be thrilled about everything that comes our way!

Healthy Menu Choices Act Misses the Mark

I knew the Healthy Menu Choices Act was being implemented as of January 1, 2017.  However, I was caught off guard when I stood in line, waiting to order a burrito and saw the calorie count beside menu items glaring back at me. I was acutely aware of the sick part of my brain, reminding me that even after all these years, I am not immune to the triggers that wreak havoc on many who have, had or will develop an eating disorder. 

I’ve heard the argument that people who struggle with the display of calories should ‘just not look’. It’s not that easy. It’s like trying to read a paragraph and having to stop part way through, not knowing if you received all the necessary information, yet don’t want to risk over reading. Or, driving past an accident while continuing to only look forward. Let’s also not forget that eating disorders are a mental illness. Those who struggle aren’t thinking about food in the same way you may be. It’s not easy for them to simply order what they want. It’s real, it’s a struggle. Mental gymnastics occur, contemplating every angle of each menu item. Is it pro-recovery or will it keep me sick? If I order ‘A’, will people think I don’t have an eating disorder any more and think everything is back to ‘normal’ when it’s not?  Throw people with eating disorders or in recovery into a society that is largely distorted around food, weight, body-image, exercise and so on, and the battle becomes that much harder. It’s just one more thing to face, making it that much more difficult for them to maintain a healthy relationship with food. 

Even if you don’t or haven’t had an eating disorder, the calorie display is not helpful. When we look at ‘health’, we need to move past the idea that it is simply physical. We must learn to also have a heathy relationship with food mentally, emotionally, spiritually and socially.  Decisions solely based off of numbers take away from our ability to eat what we want instead of what society says we ‘should’ have. We need to learn the skills necessary to help cope and tolerate our emotions, instead of using food as a method to numb, stuff or comfort. We need to learn how to eat mindfully. We need to start trusting that our bodies will fall within a weight range that it likes to be in (aka set point), rather than choosing a range we think is right based on what society tells us is ‘best’. We need to understand how our bodies work when we eat higher or lower amounts of calories in a day.

I’m all up for people being aware of what and how they are eating, if they are seeking to become educated and self-aware. I understand that some people have to make very conscientious menu choices due to medical or specific dietary needs. I would suggest that the information be made available, but in its entirety. This would involve showing all nutrients, as opposed to just calories, and have them listed somewhere more discrete. Simply putting the calorie count on the menu does not paint the whole picture. It’s a poor attempt to teach people about healthy choices, and I would argue it’s more harmful than helpful. 

Andrea LaMarre, who sits on various committee to promote healthy relationships with food, weight and body-image, started a petition to repeal the Healthy Menu Choices Act. Let the Ontario Government know your thoughts on this matter.

Prepping For the Holidays

It's that time again! Holiday time. For some, this brings feelings of excitement and anticipation. While others, stress and a longing to go into a slight hibernation in hopes of by-passing the whole thing is on par. For the former, rock on and see you in 2017. For the latter, read on and hopefully, some of the strategies below will help make this time a little easier, or perhaps, even enjoyable.

#1 Plan Something You Like To Do: It's okay to make plans to do something you like. This can help balance some of the holiday activities you may not have much say about. Maybe it's going for a winter walk, or watching movies by a fire place. Explore the downtown shops or the local cafes you've always wanted to try. Whatever you like to do, plan time to do it or else you run the risk of time slipping by and another holiday season that you did not really enjoy will result. Remember, you don't have to do anything big or expensive in order for it to be fun, enjoyable or peaceful... or whatever it is you want it to bring into your holiday. 

#2 Intentionally Create Positive Experiences: You know that Christmas function at Aunt Gertrude's you attend every year with reluctance? Spice it up a little by intentionally creating a positive experience. This could be anything from wearing your favourite ugly sweater to bringing a game everyone can play. Maybe you invite your best friend to help ease the awkward yearly questions asked by family members or you make it your mission to sit beside your most liked cousin whom you can chat up a storm with over dinner. Whatever it is, putting some thought and effort into how you can make the best of the event has to be better than doing nothing and expecting the worse! Maybe it still won't be the best time you've ever had, but maybe it's slightly better than you anticipated. 

#3 Find Balance Between Social and Alone Time: This could go either way. Maybe you tend to isolate over the holidays, or perhaps you have difficulty saying 'no' to people.  Try to find time for social and alone/down time. This way, you don't run the risk of being lonely, or over booked to the point of exhaustion! Isolating will only make the time go by slower and over booking will leave you worn out and needing a holiday from your holiday. 

#4 Don't Forget to Take Your M n M's (Meds and Meals): Your routine and schedule will likely be nudge off track over the holidays. Maybe you're staying up later or going out of town more often than usual. Try to continue maintaining some of the basics in your recovery and wellness. Set an alarm to take your medication and meals so you don't run the risk of forgetting. Keep doing the necessary basics to help maintain your recovery instead of slipping backwards.

#5 Prepare for High Risk Situations: Don't go into the holidays thinking you can wing it. Take some time to know what activities or situations you are going into that are likely going to be stressful, or potentially triggering. This way, you can come up with a plan for how to manage them successfully. Write up a list of counter statements you can use when Uncle Mickey starts making unhelpful comments about weight or when Cousin Mildred gets on about calories. Use opposite action when presented with a food your E.D. is telling you not to have but you know you use to really enjoy. Know who you can call or text in times of trouble or stress. Go to your calm or safe place when you feel unsafe or distressed. In some ways, preparing for high risk situations is like fire drills. They help prepare you in case there is ever a fire to maximize safety and minimize harm.   

And remember... regardless of how the holidays go... they will not last forever. Hang in there. One meal at a time, one day at a time, one event at a time. Be gently with yourself, and ease off the perfectionism a little. Allow yourself to say, 'no', when you need to, and 'yes' when you want to. Look at cat pictures of the internet.... like this one. Take time to smile every once and awhile and just 'be'. 

(I couldn't resist this little guy... love hairless cats!)

Accessed from: https://commons.wikimedia.org/wiki/File:2_weekold_Female_Sphynx_(Suki).jpg Dec.12, 2016

Container and Safe Place

Last year, I completed training in Eye Movement Reprocessing and Desensitization (E.M.D.R.) and was introduced to the skills of 'container/containment' and 'safe/calm place'. Other therapy modalities also use these skills. I love them! Especially safe place. Both involve visualization and can help decrease anxiety. Give them a try!

So, container/containment. Close your eyes for a moment. Think of some sort of container that is strong and sturdy. Something that you can put things into that you know won't be able to get out. When I close my eyes and do this, I see a treasure chest box. Black/grey-ish, with rusted metal trim on its seams. There's a latch with a key hole to keep it locked. It's a special kind of chest in that it is a bottomless container... sort of like Hermione's bag (for all you Harry Potter fans) that contains endless amount of things. When I'm feeling distressed, or have too many thoughts roaming around in my head that keep me from falling asleep or focusing at the task at hand, I put them in this container. I visualize every worry and painful feeling I can't attend to in this moment flying into this container. I shut the lid *thud* and slide it to the back corner in the basement, where it's dark and dingy... cobwebs in the corners and ceiling. It sits there until I allow myself to pull it out.

The concept of the container isn't meant for you to be in denial of the painful things you put in there... it's not meant to be locked up forever (because we all know that doesn't work!). But, it gives yourself permission to take a break from it for a bit. Then, perhaps when you are in your  next therapy appointment, or with a trusted support person, you allow yourself to take it out again and work on it. 

Next is calm/safe place. If you prefer the word calmness over safety, that is okay. It is not important which word you choose to reference this place, as long as it is a place where calmness and peace resides. 

Similarly to container, visualize a place that is filled with everything calm and safe. It can be real, or imaginary. Are you alone or with someone? Any animals there? What is in your surroundings? Can you hear anything? Are you inside or outside? Any smells or tastes? What can you feel? 

My calm place has changed over the years. It used to be a remote shoreline of a lake up North, near White Otter Castle, that awaited me after completing a portage. There was a pebble beach with various trees (oak, maple, birch, pine) defining the shoreline. It was summer time, blue sky, warm and no bugs. There is a sense of awe and wonder here, as well as relief. There is no wind, the water is calm, although I can hear it lap up against the pebbles. In reality, there were more people there, but in my calm place, it is just me. It is a first person view. I don’t have a physical picture of this place… but it is so clear in my mind.

I can go there whenever I want. I can go there when I’m alone or in a crowd.  And, if for whatever reason, this place somehow becomes ‘tainted’ and is no longer calm or safe, I can let it go and think up a new place. Same with the container… if when pulling it up in your mind you feel as though it won’t do the job you need it to, think up something new or different. Add things to it or start fresh. So, next time you are needing some ‘calmness’ in your life, try putting your distress in a container and then visually going to your calm place!