Karen Kerschmann, LCSW

Cognitive Behavioral Therapy and Clinical Supervision

 

Kerschmann & Associates

Cognitive Behavioral Therapy and  Clinical Supervision

Kerschmann & Associates

Cognitive Behavioral Therapy and  Clinical Supervision

Video: Understanding the Biology of Stress Symptoms- Cognitive Therapy in San Diego

by | Jun 17, 2024 | Anxiety, Anxiety and Stress, Anxious Feelings, Anxious Thoughts, Cognitive Behavioral Therapy, Uncategorized

Video- How Does a Therapist Treat Anxiety Disorder? An Introduction to CBT Skills

If you are reading this, chances are you already know that symptoms of stress can feel overwhelming and, if untreated, can evolve into an anxiety disorder. The good news is understanding the biological roots can be the first step toward success.  In this video,  ‘Master Your Mind: Essential CBT Skills for Anxiety Symptoms,’ Dr. Rosalie Zuniga from Postpartum Wellness and I discuss what information I provide to clients in the first stages of anxiety treatment. If you want to know about the mind-body connection when you experience anxiety symptoms, check out the first part of this video to dive into the biology of stress. You can find more content in the second part if you’d like to try some practical strategies for managing anxiety disorder. Are you curious but not ready to watch the whole video? You can find an overview below.

 

The Biological Roots of Anxiety Disorders

Anxiety is more than an emotion; it’s an interplay of biology and psychology. The ‘fight, flight, freeze, fawn’ response is an instinct we have to stress or danger. This is also known as the ‘stress response’. In the modern world, this is not particularly useful. In very few situations, this phenomenon may be helpful (like if a bear is chasing you). However, when we ruminate about our fears, our brain believes we are actually in physical danger, and if it persists, it can evolve into an anxiety disorder.

Anxiety Symptoms

The symptoms of anxiety can vary but have some specific themes:

  1. Excessive Worry: Constant, uncontrollable worry about everyday things.
  2. Physical Anxiety Symptoms: These can include increased heart rate, sweating, trembling, dizziness, and shortness of breath.
  3. Trouble Concentrating: Difficulty focusing on tasks or making decisions.
  4. Sleep Problems: Trouble falling asleep, staying asleep, or restless sleep.
  5. Avoidance: Avoiding situations that cause anxiety can impact daily life and activities.
  6. Panic Attacks: Sudden episodes of intense fear or discomfort, often accompanied by physical symptoms like chest pain or a feeling of choking.

It’s the Thought that Counts

As you have learned, biological reactions to specific triggers creates the stress response. It’s just as important to recognize that avoidance of triggers and catastrophizing will feed the belief that we can’t handle our complex emotions, which leads to anxiety.  Below is a helpful equation from Dr. Aaron Beck, the father of Cognitive Behavioral Therapy (CBT)

Dangerous Thinking + Helpless Thinking = Level of Anxiety Symptoms

Dangerous Thinking:

Imagine someone who experiences a setback at work, such as not receiving the promotion they expected. They might engage in dangerous thinking by catastrophizing the situation. For instance:

“I failed, which confirms I’m not good enough. What if people find out? Everyone at work will know I’m incompetent.”

Helpless Thinking:

Helpless thinking involves believing that whatever the imagined catastrophe is, they will not be able to handle it.

Using the same situation, this person may think, ‘I am so embarrassed, and now I have to go to work after this rejection. I’ll be in the bathroom crying all day. I will sit in silence in meetings, and I won’t be able to be of any use now because I’ll be a mess. I don’t think I’ll be able to date because I’ll just keep thinking about how inferior I am.’

CBT in Action:

The video ‘Transform Your Anxiety Symptoms: CBT Skills to Help You Feel Better’ discusses several interventions, such as ‘Decatastrophizing the Fear (Worst Case Scenario)’ and the ‘What Ifs’ to examine and test dangerous thoughts.

Although in a stressed state, we overpredict dangerous outcomes, the reality is that the worst case can happen. Our helpless thinking kicks in when we anticipate we can’t handle the worst-case scenario. I will ask my clients, ‘How could you cope in a healthy and strong way?’ ‘Is there a way you visualize managing the catastrophe in a way you would be proud of?’ My clients who come to me for anxiety treatment in San Diego often will hear me joke that we are not the fragile flowers we believe we are. All humans can survive and thrive under challenging circumstances, which is a vital understanding to manage anxious thoughts.

Where to Find More Information: Therapy in San Diego

For more details about this insightful session and to explore additional resources, visit Therapy in San Diego and Postpartum Wellness. If you are curious about your anxiety symptoms and wonder if you would benefit from treatment, head to Anxiety Treatment in San Diego – Assessment to see where you land on the anxiety disorder scale.

 

Transforming Your Unhelpful Core Beliefs with CBT

by | Mar 13, 2024 | Anxious Thoughts, Cognitive Behavioral Therapy

What are Core Beliefs and Why are they so Important to Our Mental Health? 

 

Core beliefs are deeply ingrained convictions that individuals hold about themselves, others, and the world around them. These arefundamental to one’s sense of self and play a significant role in shaping thoughts, emotions, and behaviors. Core beliefs are often formed early in life through various experiences, interactions, and socialization.

This text shows untangling of a core belief

These thoughts tend to be stable over time unless they are consciously challenged and modified. Positive core beliefs contribute to a healthy self-esteem and resilient mindset, while negative core beliefs can lead to self-doubt, low self-worth, and psychological distress.

Examples of core beliefs include:

– I am unlovable and unworthy of affection

– I am worthy of love and respect

– I am incompetent and destined to fail

– I am capable enough

– I am fundamentally flawed and defective

– I am deserving of success and happiness

– Others will always reject or betray me

– Others are generally trustworthy and kind

It’s easy to see how core beliefs serve as the lens through which individuals interpret their experiences and perceive themselves and the world at a subconscious level. These are the ‘roots’ of our psychological tree, and it takes conscious and consistent efforts to change.

In Cognitive Behavioral Therapy (CBT), these core beliefs are a central focus. Cognitive behavioral therapists work with clients to identify and challenge negative core beliefs, replacing them with more adaptive and constructive beliefs. This process, known as cognitive restructuring, helps individuals develop a healthier self-concept and achieve greater emotional well-being.

One exercise I use in my CBT practice is a positive data log:

Using CBT’s Positive Data Log

A Positive Data Log is easy to create. Here is a template for your reference.

Step 1: Identify the Unhelpful Core Belief

In this case, we will use ‘I’m not good enough’

Step 2: Develop a more useful alternative belief

Let’s use ‘I’m good enough’

It’s important to note that the goal is to not convince yourself of the opposite of your core belief, but more of a balanced perception of yourself. ‘I’m good enough’ doesn’t allude to ‘I’m perfect’.

Step 3: List evidence from your recent experiences that contradict or challenge the core belief. 

These would be instances where you succeeded, received positive feedback, or felt valued. The more specific the evidence, the more helpful it will be. Additionally, it’s very important to recognize the small pieces of evidence we may be ignoring.

Some evidence may look like this:

– My friend Mark called me to say ‘hi’

– I completed my grocery shopping on my own

– I didn’t get fired today

– Barbara laughed when I made a joke

– A stranger made small talk with me

– My dog was excited to see me when I got home

Last words on Positive Data Logs

Be Patient

Adding to this this positive data log every day can help reinforce useful self-beliefs and challenge negative thinking patterns. This is a long-term practice; we spend our whole lives living through a certain lens, so it takes time to shift. Patience is key here! Many people find that a therapist or other support is vital to stay accountable and also to review and process the evidence collected.

Expect Your Brain to Push Back

It’s natural to find yourself hearing ‘yes but’ after writing down evidence that contradicts our core beliefs. If you find you are having trouble accepting the new evidence, be gentle and remind yourself that you will have time to focus on the opposing data, but for now, you are just collecting some positive information.

Positive data logs are an effective, CBT based method of challenging the unhelpful ways we view ourselves and our world. Used consistently, you can find yourself shifting into a more balanced and rewarding mindset.