Dr. Kovner’s approach to psychotherapy is eclectic. His mode of therapy has been shaped and influenced by Erick Erickson, B.F. Skinner, Alfred Adler, Carl Rogers, John Gottman, Sue Johnson, and many more. He uses Cognitive Behavior Therapy, as well as Interpersonal Psychotherapy which is based on attachment theory. In Attachment Theory, the early relationship bonds or attachments we form with our parents can be loving and nurturing or dysfunctional and unstable. These early experiences form the basis for personal identity and self-esteem and shape our ability to form healthy adult attachments, or unstable damaged ones.
Cognitive Behavior Therapy
Based on the work of Aaron Beck, M.D., Albert Ellis and others, Cognitive Behavior Therapy provides the best relief from symptoms of depression, anxiety, rage, compulsions, and many other conditions that impair human behavior. Let’s look at the 5 areas most affected by stress:
● Environment: The environment includes our place of work and the people we work with; schoolmates, family and friends. We can affect our environment, or be affected by it.
● Mood: Our feelings or emotions guide our behavior. When we experience positive emotions of happiness, peace and powerfulness, we behave successfully in our personal goals, family life and career. When our moods are negative, sadness, worry and anger direct us to withdraw, panic and act aggressively.
● Physical Health: We can be negatively affected by our health, or our health can be a source of great resilience and strength. When we feel physically ill, our mood is often depressed and irritable. We act withdrawn, don’t want to be around others or participate in social events. People find us difficult to deal with or may pity us. We may be unable to concentrate or perform work. When we feel physically ill, we may ruminate about our illness and think life is not worth living. When our physical health improves, we find renewed energy and interest in others and in life. We may think more creatively and act in ways that are more social and improve our ability to work and remember.
● Behavior: Defined by our actions. How we act can cause stress or stress can make us act in ineffective or destructive ways. When we behave in ways that are destructive, ineffective or aggressive, we impact the people in our environment, it can make us feel physically worse, raise our blood pressure, produce head and stomach aches and emotionally, can produce irritable and angry moods. Behaving in aggressive and destructive ways produces judgmental opinions of others and of oneself.
● Thinking: When our thoughts, opinions, beliefs, ideas or perceptions are based on faulty logic, our ability to plan, think ahead of the consequences, organize ourselves to make decisions and solve problems degrades our capacity to cope. The result is an intensification of sadness into depression, worry and fear into anxiety and anger into rage. When we grasp the distortion in our thinking and correct our faulty logic, we are more capable of using our executive functions. This includes planning, organizing, paying attention and regulating mood so that we can attain our goals and achieve happiness, peace and powerfulness.
6 STEPS TO BETTER MENTAL HEALTH
A small improvement in any one of the above 5 areas has a general healing effect on the other four.
- Step 1: The first thing we do is identify is the upsetting event causing the stress.
- Step 2: Then describe your belief or opinion about that event and rate, on a scale of 0 to 10, how strongly you believe that opinion on a scale from “0 to 10” with a “10” meaning I believe this opinion completely and a “0” meaning I don’t believe this opinion at all.
- Step 3: Next, ask yourself how this way of thinking makes you feel and how it affects your environment, behavior, and physical health.
- Step 4: Now, rate the intensity of your mood on a scale from “0 to 10” with a “10” meaning I feel this way completely and a “0” meaning I don’t feel this way at all.
Ask yourself, “Which belief accounts for the strongest mood?” That is the “Hot Thought” and the place to begin to analyze your thinking.
- Step 5: What evidence supports your belief and what evidence can you think of that does not support it? Ask yourself, what is another way to think about this event? What might be a more balanced way to think about it? How can I avoid making thinking errors?
- Step 6: Go back and rate how strongly you believe the original belief and the associated moods. Rate them again on a scale from 0 to 10.
THINKING ERRORS OR COGNITIVE DISTORTIONS
1. All Or Nothing Thinking: You look at things in absolute, black or white categories (e.g.,I can’t at all or it’s all too hard).
2. Overgeneralization: You view an event as a never-ending pattern of defeat. The ability to generalize from one experience may be called a “hunch” or “intuition.” However, when you overgeneralize you fail to see the important differences in the details and changes in your experiences of reality.
3. Mental Filter: You dwell on the negatives.
4. Discounting the Positives: You insist that your accomplishments or positive qualities don’t count.
5. Jumping to Conclusions:
A. Mind-Reading: You assume that people are reacting negatively to you when there is no definite evidence.
B. Fortune Telling: You arbitrarily predict that things will turn out badly.
6. Magnification or Minimization: You blow things way out of proportion and ususally it is accompanied by “trigger words” – What if? What if? What if? What if? What if? The opposite of catastrophizing is minimizing or shrinking the importance of things (e.g.,”I only stole one thing from the store,” or “At least I got a high F on the exam.”)
7. Emotional Reasoning: You reason from how you feel. (e.g.,” I feel like an idiot, therefore, I must be an idiot.”)
8. Should have…, Would have…, Could have… Statements: You criticize yourself (or other people) with shoulds, ought tos; musts; and have tos, etc.
9. Labeling: Instead of saying “I made a mistake;” you tell yourself, “I’m a jerk, a fool or a loser.”
10. Personalization and Blame: You blame yourself for something you weren’t entirely responsible for, or you blame other people and deny your role in the problem. Now, how do you feel? How does this new way of thinking about the event affect your mood, your behavior, your physical health, and your environment? You’ll feel a sense of relief from this very brief intervention. Over time, you will be able to do CTB quickly and effectively by yourself.
Transactional Analysis focuses on the neurological pathways developed by early attachments and provide methods for changing those pathological pathways, or scripts, that tend to be acted upon without insight or self-awareness.
Cognitive Behavior Therapy Read More
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