Radical CBT
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Radical Acceptance!
A common criticism of Cognitive Behavioral Therapy (CBT) is that much of it hinges on the following process:
- You are having bad feelings
- Which were caused by negative automatic thoughts
- Which can be taken apart logically
- Thus diffusing the feelings
- And then feeling better
For example:
- I feel like I’m an unwanted burden to my friend
- Because he canceled on me today
- But a reasonable explanation is that he indeed accidentally double-booked himself and the other thing wasn’t re-arrangeable
- My friend is trusting me to be an understanding friend myself, and greatly values my friendship
- I feel better and look forward to our next time together
But what if the negative automatic thoughts are, upon examination, reasonable?
Does CBT argue that we should just “keep the faith” and go on looking at a cruel indifferent world through rose-tinted spectacles?
Nope, there’s a back-up tool.
This is more talked-about in Dialectic Behavior Therapy (DBT), and is called radical acceptance:
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Radical acceptance here means accepting the root of things as true, and taking the next step from there. It follows a bad conclusion with “alright, and now what?”
“But all evidence points to the fact that my friend has been avoiding me for months; I really can’t ignore it or explain it away any longer”
“Alright. Now what?”
- Maybe there’s something troubling your friend that you don’t know about (have you asked?)
- Maybe that something is nothing to do with you (or maybe it really is about you!)
- Maybe there’s a way you and he can address it together (how important is it to you?)
- Maybe it’s just time to draw a line under it and move on (with or without him)
Whatever the circumstances, there’s always a way to move forwards.
Feelings are messengers, and once you’ve received and processed the message, the only reason to keep feeling the same thing, is if you want to.
Note that this is true even when you know with 100% certainty that the Bad Thing™ is real and exactly as-imagined. It’s still possible for you to accept, for example:
“Alright, so this person really truly hates me. Damn, that sucks; I think I’ve been nothing but nice to them. Oh well. Shit happens.”
Feel all the feelings you need to about it, and then decide for yourself where you want to go from there.
Get: 25 CBT Worksheets To Help You Find Solutions To A Wide Variety of Problems
Recognizing Emotions
We talked in a previous edition of 10almonds’ Psychology Sunday about how an important part of dealing with difficult emotions is recognizing them as something that you experience, rather than something that’s intrinsically “you”.
But… How?
One trick is to just mentally (or out loud, if your current environment allows for such) greet them when you notice them:
- Hello again, Depression
- Oh, hi there Anxiety, it’s you
- Nice of you to join us, Anger
Not only does this help recognize and delineate the emotion, but also, it de-tooths it and recognizes it for what it is—something that doesn’t actually mean you any harm, but that does need handling.
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Thinking of using an activity tracker to achieve your exercise goals? Here’s where it can help – and where it probably won’t
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It’s that time of year when many people are getting started on their resolutions for the year ahead. Doing more physical activity is a popular and worthwhile goal.
If you’re hoping to be more active in 2024, perhaps you’ve invested in an activity tracker, or you’re considering buying one.
But what are the benefits of activity trackers? And will a basic tracker do the trick, or do you need a fancy one with lots of features? Let’s take a look.
Why use an activity tracker?
One of the most powerful predictors for being active is whether or not you are monitoring how active you are.
Most people have a vague idea of how active they are, but this is inaccurate a lot of the time. Once people consciously start to keep track of how much activity they do, they often realise it’s less than what they thought, and this motivates them to be more active.
You can self-monitor without an activity tracker (just by writing down what you do), but this method is hard to keep up in the long run and it’s also a lot less accurate compared to devices that track your every move 24/7.
By tracking steps or “activity minutes” you can ascertain whether or not you are meeting the physical activity guidelines (150 minutes of moderate to vigorous physical activity per week).
It also allows you to track how you’re progressing with any personal activity goals, and view your progress over time. All this would be difficult without an activity tracker.
Research has shown the most popular brands of activity trackers are generally reliable when it comes to tracking basic measures such as steps and activity minutes.
But wait, there’s more
Many activity trackers on the market nowadays track a range of other measures which their manufacturers promote as important in monitoring health and fitness. But is this really the case? Let’s look at some of these.
Resting heart rate
This is your heart rate at rest, which is normally somewhere between 60 and 100 beats per minute. Your resting heart rate will gradually go down as you become fitter, especially if you’re doing a lot of high-intensity exercise. Your risk of dying of any cause (all-cause mortality) is much lower when you have a low resting heart rate.
So, it is useful to keep an eye on your resting heart rate. Activity trackers are pretty good at tracking it, but you can also easily measure your heart rate by monitoring your pulse and using a stopwatch.
Heart rate during exercise
Activity trackers will also measure your heart rate when you’re active. To improve fitness efficiently, professional athletes focus on having their heart rate in certain “zones” when they’re exercising – so knowing their heart rate during exercise is important.
But if you just want to be more active and healthier, without a specific training goal in mind, you can exercise at a level that feels good to you and not worry about your heart rate during activity. The most important thing is that you’re being active.
Also, a dedicated heart rate monitor with a strap around your chest will do a much better job at measuring your actual heart rate compared to an activity tracker worn around your wrist.
Maximal heart rate
This is the hardest your heart could beat when you’re active, not something you could sustain very long. Your maximal heart rate is not influenced by how much exercise you do, or your fitness level.
Most activity trackers don’t measure it accurately anyway, so you might as well forget about this one.
VO₂max
Your muscles need oxygen to work. The more oxygen your body can process, the harder you can work, and therefore the fitter you are.
VO₂max is the volume (V) of oxygen (O₂) we could breathe maximally (max) over a one minute interval, expressed as millilitres of oxygen per kilogram of body weight per minute (ml/kg/min). Inactive women and men would have a VO₂max lower than 30 and 40 ml/kg/min, respectively. A reasonably good VO₂max would be mid thirties and higher for women and mid forties and higher for men.
VO₂max is another measure of fitness that correlates well with all-cause mortality: the higher it is, the lower your risk of dying.
For athletes, VO₂max is usually measured in a lab on a treadmill while wearing a mask that measures oxygen consumption. Activity trackers instead look at your running speed (using a GPS chip) and your heart rate and compare these measures to values from other people.
If you can run fast with a low heart rate your tracker will assume you are relatively fit, resulting in a higher VO₂max. These estimates are not very accurate as they are based on lots of assumptions. However, the error of the measurement is reasonably consistent. This means if your VO₂max is gradually increasing, you are likely to be getting fitter.
So what’s the take-home message? Focus on how many steps you take every day or the number of activity minutes you achieve. Even a basic activity tracker will measure these factors relatively accurately. There is no real need to track other measures and pay more for an activity tracker that records them, unless you are getting really serious about exercise.
Corneel Vandelanotte, Professorial Research Fellow: Physical Activity and Health, CQUniversity Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Regular Nail Polish vs Gel Nail Polish – Which is Healthier?
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Our Verdict
When comparing regular nail polish to gel nail polish, we picked the regular.
Why?
This one’s less about what’s in the bottle, and more about what gets done to your hands:
- Regular nail polish application involves carefully brushing it on.
- Regular nail polish removal involves wiping with acetone.
…whereas:
- Gel nail polish application involves deliberately damaging (roughing up) the nail to allow the color coat to adhere, then when the top coat is applied, holding the nails (and thus, the attached fingers) under a UV light to set it. That UV lamp exposure is very bad for the skin.
- Gel nail polish removal involves soaking in acetone, which is definitely worse than wiping with acetone. Failure to adequately soak it will result in further damage to the nail while trying to get the base coat off the nail that you already deliberately damaged when first applying it.
All in all, regular nail polish isn’t amazing for nail health (healthiest is for nails to be free and naked), but for those of us who like a little bit of color there, regular is a lot better than gel.
Gel nail polish damages the nail itself by necessity, and presents a cumulative skin cancer risk and accelerated aging of the skin, by way of the UV lamp use.
For your interest, here are the specific products that we compared, but the above goes for any of this kind:
Regular nail polish | Gel nail polish
If you’d like to read more about nail health, you might enjoy reading:
The Counterintuitive Dos and Don’ts of Nail Health
Take care!
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Is it OK to lie to someone with dementia?
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There was disagreement on social media recently after a story was published about an aged care provider creating “fake-away” burgers that mimicked those from a fast-food chain, to a resident living with dementia. The man had such strict food preferences he was refusing to eat anything at meals except a burger from the franchise. This dementia symptom risks malnutrition and social isolation.
But critics of the fake burger approach labelled it trickery and deception of a vulnerable person with cognitive impairment.
Dementia is an illness that progressively robs us of memories. Although it has many forms, it is typical for short-term recall – the memory of something that happened in recent hours or days – to be lost first. As the illness progresses, people may come to increasingly “live in the past”, as distant recall gradually becomes the only memories accessible to the person. So a person in the middle or later stages of the disease may relate to the world as it once was, not how it is today.
This can make ethical care very challenging.
Pikselstock/Shutterstock Is it wrong to lie?
Ethical approaches classically hold that specific actions are moral certainties, regardless of the consequences. In line with this moral absolutism, it is always wrong to lie.
But this ethical approach would require an elderly woman with dementia who continually approaches care staff looking for their long-deceased spouse to be informed their husband has passed – the objective truth.
Distress is the likely outcome, possibly accompanied by behavioural disturbance that could endanger the person or others. The person’s memory has regressed to a point earlier in their life, when their partner was still alive. To inform such a person of the death of their spouse, however gently, is to traumatise them.
And with the memory of what they have just been told likely to quickly fade, and the questioning may resume soon after. If the truth is offered again, the cycle of re-traumatisation continues.
People with dementia may lose short term memories and rely on the past for a sense of the world. Bonsales/Shutterstock A different approach
Most laws are examples of absolutist ethics. One must obey the law at all times. Driving above the speed limit is likely to result in punishment regardless of whether one is in a hurry to pick their child up from kindergarten or not.
Pragmatic ethics rejects the notion certain acts are always morally right or wrong. Instead, acts are evaluated in terms of their “usefulness” and social benefit, humanity, compassion or intent.
The Aged Care Act is a set of laws intended to guide the actions of aged care providers. It says, for example, psychotropic drugs (medications that affect mind and mood) should be the “last resort” in managing the behaviours and psychological symptoms of dementia.
Instead, “best practice” involves preventing behaviour before it occurs. If one can reasonably foresee a caregiver action is likely to result in behavioural disturbance, it flies in the face of best practice.
What to say when you can’t avoid a lie?
What then, becomes the best response when approached by the lady looking for her husband?
Gentle inquiries may help uncover an underlying emotional need, and point caregivers in the right direction to meet that need. Perhaps she is feeling lonely or anxious and has become focused on her husband’s whereabouts? A skilled caregiver might tailor their response, connect with her, perhaps reminisce, and providing a sense of comfort in the process.
This approach aligns with Dementia Australia guidance that carers or loved ones can use four prompts in such scenarios:
- acknowledge concern (“I can tell you’d like him to be here.”)
- suggest an alternative (“He can’t visit right now.”)
- provide reassurance (“I’m here and lots of people care about you.”)
- redirect focus (“Perhaps a walk outside or a cup of tea?”)
These things may or may not work. So, in the face of repeated questions and escalating distress, a mistruth, such as “Don’t worry, he’ll be back soon,” may be the most humane response in the circumstances.
Different realities
It is often said you can never win an argument with a person living with dementia. A lot of time, different realities are being discussed.
So, providing someone who has dementia with a “pretend” burger may well satisfy their preferences, bring joy, mitigate the risk of malnutrition, improve social engagement, and prevent a behavioural disturbance without the use of medication. This seems like the correct approach in ethical terms. On occasion, the end justifies the means.
Steve Macfarlane, Head of Clinical Services, Dementia Support Australia, & Associate Professor of Psychiatry, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Kettlebell Swings Are Not What Most People Think They Are (They’re Better)
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Commonly assumed to be mostly a shoulders-and-arms exercise, they’re actually mostly about the hips and core:
From the hips
Correctly executed kettlebell swings primarily strengthens muscles from the hamstrings and glutes the to abs and back; in other words, muscles whose strength is essential for power, posture, and injury prevention.
The core in particular is not to be underestimated, with deep stabilizing muscles supporting posture, balance, and movement. Strengthening these areas can also help reduce lower back pain.
How to do it correctly: start with your feet shoulder-width apart (this is important, if you like having knees) and grip the kettlebell with both hands. Hinge at your hips, lowering the kettlebell between your legs while keeping your back flat and core engaged. Then, drive your hips forward explosively to swing the kettlebell up to shoulder height before allowing it to return down with control. The most common mistake is using the arms to lift the kettlebell, but the real power should come from the hips to maximize benefits and prevent injury.
Example workout: 30 seconds of kettlebell swings followed by 30 seconds of rest, repeated for 10 sets. This 10-minute routine provides a full-body workout that builds strength and endurance. As you progress, you can increase the weight, duration, number of sets, etc.
Timeline of changes: within a few weeks of regular kettlebell swings, you should notice stronger glutes, better endurance, and improved posture. After a month, you may experience reduced lower back pain (if you had lower back pain) and more power in your everyday movements. By two to three months, visible muscle definition and fat loss are likely to become noticeable, along with increased overall strength.
For more on all of this plus visual demonstrations, enjoy:
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Want to learn more?
You might also like:
Body Sculpting with Kettlebells for Women – by Lorna Kleidman
Take care!
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Is alcohol good or bad for you? Yes.
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This article originally appeared in Harvard Public Health magazine.
It’s hard to escape the message these days that every sip of wine, every swig of beer is bad for your health. The truth, however, is far more nuanced.
We have been researching the health effects of alcohol for a combined 60 years. Our work, and that of others, has shown that even modest alcohol consumption likely raises the risk for certain diseases, such as breast and esophageal cancer. And heavy drinking is unequivocally harmful to health. But after countless studies, the data do not justify sweeping statements about the effects of moderate alcohol consumption on human health.
Yet we continue to see reductive narratives, in the media and even in science journals, that alcohol in any amount is dangerous. Earlier this month, for instance, the media reported on a new study that found even small amounts of alcohol might be harmful. But the stories failed to give enough context or probe deeply enough to understand the study’s limitations—including that it cherry-picked subgroups of a larger study previously used by researchers, including one of us, who concluded that limited drinking in a recommended pattern correlated with lower mortality risk.
“We need more high-quality evidence to assess the health impacts of moderate alcohol consumption. And we need the media to treat the subject with the nuance it requires. Newer studies are not necessarily better than older research.”
Those who try to correct this simplistic view are disparaged as pawns of the industry, even when no financial conflicts of interest exist. Meanwhile, some authors of studies suggesting alcohol is unhealthy have received money from anti-alcohol organizations.
We believe it’s worth trying, again, to set the record straight. We need more high-quality evidence to assess the health impacts of moderate alcohol consumption. And we need the media to treat the subject with the nuance it requires. Newer studies are not necessarily better than older research.
It’s important to keep in mind that alcohol affects many body systems—not just the liver and the brain, as many people imagine. That means how alcohol affects health is not a single question but the sum of many individual questions: How does it affect the heart? The immune system? The gut? The bones?
As an example, a highly cited study of one million women in the United Kingdom found that moderate alcohol consumption—calculated as no more than one drink a day for a woman—increased overall cancer rates. That was an important finding. But the increase was driven nearly entirely by breast cancer. The same study showed that greater alcohol consumption was associated with lower rates of thyroid cancer, non-Hodgkin lymphoma, and renal cell carcinoma. That doesn’t mean drinking a lot of alcohol is good for you—but it does suggest that the science around alcohol and health is complex.
One major challenge in this field is the lack of large, long-term, high-quality studies. Moderate alcohol consumption has been studied in dozens of randomized controlled trials, but those trials have never tracked more than about 200 people for more than two years. Longer and larger experimental trials have been used to test full diets, like the Mediterranean diet, and are routinely conducted to test new pharmaceuticals (or new uses for existing medications), but they’ve never been done to analyze alcohol consumption.
Instead, much alcohol research is observational, meaning it follows large groups of drinkers and abstainers over time. But observational studies cannot prove cause-and-effect because moderate drinkers differ in many ways from non-drinkers and heavy drinkers—in diet, exercise, and smoking habits, for instance. Observational studies can still yield useful information, but they also require researchers to gather data about when and how the alcohol is consumed, since alcohol’s effect on health depends heavily on drinking patterns.
For example, in an analysis of over 300,000 drinkers in the U.K., one of us found that the same total amount of alcohol appeared to increase the chances of dying prematurely if consumed on fewer occasions during the week and outside of meals, but to decrease mortality if spaced out across the week and consumed with meals. Such nuance is rarely captured in broader conversations about alcohol research—or even in observational studies, as researchers don’t always ask about drinking patterns, focusing instead on total consumption. To get a clearer picture of the health effects of alcohol, researchers and journalists must be far more attuned to the nuances of this highly complex issue.
One way to improve our collective understanding of the issue is to look at both observational and experimental data together whenever possible. When the data from both types of studies point in the same direction, we can have more confidence in the conclusion. For example, randomized controlled trials show that alcohol consumption raises levels of sex steroid hormones in the blood. Observational trials suggest that alcohol consumption also raises the risk of specific subtypes of breast cancer that respond to these hormones. Together, that evidence is highly persuasive that alcohol increases the chances of breast cancer.
Similarly, in randomized trials, alcohol consumption lowers average blood sugar levels. In observational trials, it also appears to lower the risk of diabetes. Again, that evidence is persuasive in combination.
As these examples illustrate, drinking alcohol may raise the risk of some conditions but not others. What does that mean for individuals? Patients should work with their clinicians to understand their personal risks and make informed decisions about drinking.
Medicine and public health would benefit greatly if better data were available to offer more conclusive guidance about alcohol. But that would require a major investment. Large, long-term, gold-standard studies are expensive. To date, federal agencies like the National Institutes of Health have shown no interest in exclusively funding these studies on alcohol.
Alcohol manufacturers have previously expressed some willingness to finance the studies—similar to the way pharmaceutical companies finance most drug testing—but that has often led to criticism. This happened to us, even though external experts found our proposal scientifically sound. In 2018, the National Institutes of Health ended our trial to study the health effects of alcohol. The NIH found that officials at one of its institutes had solicited funding from alcohol manufacturers, violating federal policy.
It’s tempting to assume that because heavy alcohol consumption is very bad, lesser amounts must be at least a little bad. But the science isn’t there, in part because critics of the alcohol industry have deliberately engineered a state of ignorance. They have preemptively discredited any research, even indirectly, by the alcohol industry—even though medicine relies on industry financing to support the large, gold-standard studies that provide conclusive data about drugs and devices that hundreds of millions of Americans take or use daily.
Scientific evidence about drinking alcohol goes back nearly 100 years—and includes plenty of variability in alcohol’s health effects. In the 1980s and 1990s, for instance, alcohol in moderation, and especially red wine, was touted as healthful. Now the pendulum has swung so far in the opposite direction that contemporary narratives suggest every ounce of alcohol is dangerous. Until gold-standard experiments are performed, we won’t truly know. In the meantime, we must acknowledge the complexity of existing evidence—and take care not to reduce it to a single, misleading conclusion.
This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.
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This Naked Mind – by Annie Grace
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We’ve all read about the many, many, dangers of drinking. We’ve also probably all read about how to make the change to not drinking. Put things out of sight, tell your friends, have this rule, have this excuse (for not drinking) ready to give to people who challenge you, consider a support group, and so on.
What Annie Grace offers in this #1 bestseller is different:
A blend of mostly psychology and sociology, to examine the “liminal thinking” stages that funnel us to drink in the first place… and where that leads, and how to clamber back out of the pitcher plant we weren’t necessarily aware we were sliding into.
While she kicks off citing Jung, from a psychological perspective more of this book is CBTish, as it pertains a lot to examining the process of:
- belief—held and defended, based on the…
- conclusion—drawn, often irrationally, from the…
- experience—that we had upon acting on an…
- observation—often mistaking an illusion for the underlying…
- reality
…and how we can and often do go wrong at each step, and how little of the previous steps we can perceive at any given time.
What does this mean for managing/treating alcoholism or a tendency towards alchoholism?
It means interrupting those processes in a careful, surgically precise fashion, so that suddenly… The thing has no more power over us.
Whether you or a loved one struggle with a tendency to addiction (any addiction, actually, the advice goes the same), or are just curious about the wider factors at hand in the epidemiology of addiction, this book is for you.
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