In This Chapter
^ Taking care of the fruits of your hard work
^ Avoiding potential relapse and overcoming actual relapse
^ Sowing the seeds of love (and compassion)
M Ooking after the positive changes you’ve made is a major part of helping *Wyou stay emotionally healthy. You can nurture your belief and behaviour changes everyday. The process is a bit like watering a plant to keep it thriving. The more care you take of yourself both generally and specifically – for example, by practising your new ways of thinking and acting – the more you reduce the chances of returning to your old problematic ways.
This chapter provides tips and advice that can help you avoid relapses and manage setbacks if they do occur.
Knowing \lour Weeds from \lour Ftou/ers
Think of your life as a garden. Unhealthy, rigid ways of thinking and corresponding behaviours like avoidance, rituals, safety strategies, perfectionism, and trying too hard to please (to name but a few) are the weeds in your garden. The flowers consist of your healthy flexible thinking, such as acceptance of self and others, acceptance of uncertainty, and allowing yourself to be fallible, and your healthy behaviours, such as assertion, communication, problem-solving, and exposure (refer to Chapters 4 and 11 for more about exposure and response prevention).
No garden’s ever weed-free. Planting desirable plants isn’t enough. You need to continuously water and feed the flowers, and uproot the weeds to keep your garden healthy. If you tend your garden regularly, the weeds don’t get a chance to take hold because there you are with your trowel, digging ‘em out at the first sign of sprouting. Depending on the virulence of your weeds, you may need to use some weedkiller from time to time in the form of appropriately prescribed medication. So, Know thy garden.
After you’ve identified your unhealthy behaviours and thinking tendencies, and bedded down some healthy alternatives, you can keep a better look out for emerging weeds and keep an eye on the health of your flowers.
Ask yourself the following questions, which can help you to know your weeds from your flowers:
What areas do I most need to keep working at in order to maintain my CBT gains? The areas you identify are those where weeds are most likely to first take root.
What CBT strategies aid me most in overcoming my emotional problems? Think about the new attitudes you’ve adopted towards yourself, the world, and other people. These areas are your tender, new flowers – their delicate shoots need your attention.
What are the most useful techniques that I’ve applied to overcoming my emotional problems? Think about the new ways of behaving that you’ve adopted (daffodils) and the old ways of behaving that you’ve dropped (thistles). Stick to your new healthy behaviours and be aware of slipping back into your former unhealthy patterns of behaviour. Use an activity schedule to help you carry out beneficial routines and behaviours (JumP to Chapter 10 for more about activity scheduling).
Write down the answers to the preceding questions so that you can look at them often to remind yourself of where to put in the hoe.
Working on Weeds
This section deals with weed-related topics and offers you some suggestions on how to stop weeds from taking over your garden, anticipating where weeds are likely to grow, and how to manage the weeds that keep coming back.
Nipping Weeds in the bud
Out of the corner of your eye, you see a weed sticking up its insidious little head. You may be tempted to ignore the weed. Maybe it’ll go away or whither
And die on its own. Unfortunately, weeds seldom eliminate themselves. Assume that any weed you identify needs killing.
A common reason for ignoring resurging problems is shame (which we talk about in Chapter 17). If you feel ashamed that your problems are recurring, you may try to deny the problems, and you may avoid seeking help from professionals or support from friends, or family. You may be less likely to make a personal effort to whack down the problems in the way you did the first time.
Setbacks are a normal part of development. Human beings have emotional and psychological problems just as readily as physical problems. You don’t have to be ashamed of your psychological problems, any more than you should be ashamed of an allergy or a heart condition.
Another common reason for people ignoring the reappearance of psychological problems is Catastrophising Or assuming the worst (head to Chapter 2 for more info on thinking errors). Many people jump to the conclusion that a setback equals a return to square one – but this certainly doesn’t have to be the case. You can take the view that a problem you conquered once is at a fundamental disadvantage when it tries to take hold again. This is because you know your enemy. Use what you already know about recognising and arresting your old thinking and behaviour to help you pluck that weed before it gets too far above the ground.
Some emotional and psychological problems are more tenacious than others, for example bipolar disorder, obsessive-compulsive disorder (OCD), and eating disorders. Just because a problem’s tenacious, it doesn’t mean that it has to take over your life, or even cause you too much interference in your life. However, you can expect to meet tenacious problems again. Keep up with treatment strategies even when your original problems are no longer in evidence; doing so will help prevent a relapse.
For example, if you have a history of depression, you may notice that weeds are popping up when you do some of the following:
Begin to think in a pessimistic way about your future and your ability to cope with daily hassles.
Ruminate on past failures and on how poor your mood is. Lose interest in seeing your family and friends.
Have difficulty getting out of bed in the morning, and you want to sleep more during the day instead of doing chores or taking exercise.
If you spot these stinging nettles making their way into your otherwise floral existence, try some of these techniques:
Challenge your pessimistic thinking bias, and remind yourself that your thoughts are not accurate descriptions of reality but symptoms of your depression. (See Chapter 2 for more on thinking errors.)
Interrupt the rumination process by using task-concentration and mindfulness techniques. (We explain these in Chapter 5.)
Continue to meet with family and friends, despite your decreased interest, on the basis that doing so makes you feel better rather than worse.
Force yourself out of bed in the morning and keep an activity schedule. (Have a read of Chapter 10 for more on activity schedules.)
Whatever your specific problems, follow the preceding example: Write down your descriptions of anticipated weeds and some specific weed-killing solutions to have at hand.
Don’t ignore signs that your problems are trying to get their roots down. Be vigilant. But also be confident in your ability to use the strategies that worked before and in your ability to use them time and again, whenever you need to.
Spotting Where Weeds may grow
To prevent relapse, become aware of where your weeds are most likely to take root.
Most people, regardless of their specific psychological problems, find themselves most vulnerable to setbacks when they’re run down or under stress. If you’re overtired and under a lot of environmental stress, such as with work deadlines, financial worries, bereavement, or family/relationship difficulties, you can tend to be more prone to physical maladies, such as colds, ‘flu, and episodes of eczema. Psychological problems are no different from physical ones in this regard: They get you when you’re depleted and at alow ebb.
You may notice that some problems, like OCD, anxiety, and depression, are more evident when you’re recovering from a physical illness. Recognising this common human experience can help you to combat any shame that you may feel, and to de-catastrophise a return of your symptoms.
Compile a list of situations and environmental factors that are likely to give your weeds scope to take on triffid-like power. For example, you may be able to pinpoint Environment triggers For your depression, such as the following:
Seasonal change, especially during autumn, when the days get shorter and the weather becomes colder.
Sleep deprivation, due to work commitments, young children, illness or any other reason.
Lack of exercise and physical activity.
Day-to-day hassles piling up at once, such as the boiler breaking down in the same week that the washing machine explodes and a few extra bills arrive.
Reduced opportunity for positive social interaction with friends and family.
You can also identify Interpersonal Triggers for your depression, such as the following:
Tired and tetchy partner.
Disagreements with your partner, children, parents, or extended family. Critical or demanding boss. Disagreeable work colleagues.
Compile a list of high-risk situations for yourself, including situations that are most likely to fire up your unhealthy core beliefs (we explain core beliefs in Chapter 13), and situations that put you under strain. Creating such a list helps you to keep a clear idea of when you’re most vulnerable to relapse and identify which psychological soil is the most fertile for weed growth.
Dealing With recurrent Weeds
Some weeds just seem to keep coming back. You may think you’re rid of them, only to open your garden door to a scene from Little Shop of Horrors (‘Feed me, Seymour!’).
Some unhealthy beliefs are harder to erode than others. Core beliefs (refer to Chapter 13) are those that typically you’ve held to be true for a very long time – most of your life even. These beliefs will keep trying to take root and may be particularly resistant to your attempts to kill them off.
The best way to deal with these recurrent weeds is to not become complacent. Keep reinforcing your alternative beliefs. Keep up with activities that fill the gaps left by your addictions or preoccupation with food. Keep doing exposure and response-prevention activities (refer to Chapter 11) to combat your OCD. Trust that over time and with persistence, your new ways of thinking and acting will get stronger.
Are you unwittingly feeding your weeds? Avoidance is a major weed fertiliser. You may have developed a healthy belief, such as ‘I want to be liked by
People, but I don’t have to be. Not being liked by some people doesn’t mean that I’m unlikeable.’ And yet, if you still avoid social situations, self-expression, and confrontation, you’re giving your old belief that ‘I must be liked by everyone or it means that I am an unlikeable person!’, the opportunity to germinate.
Check out your reasons for avoiding certain situations and experiences. Are you not going to a party because you don’t want to, or because you want to avoid the possibility of others judging you negatively in some way? Are you not visiting a farm because it doesn’t interest you, or because you want to avoid contamination from pesticides?
When you spot a recurrent, mulish weed in your garden, dig it out from the root. You can kill off weeds entirely by getting the roots, And The shoots, out of the soil. Try not to make half-hearted efforts at challenging your faulty thinking. Dispute your thinking errors (Chapter 2) and push yourself back into challenging situations using your healthy coping strategies (we cover thinking errors in Chapter 2, and we talk about coping strategies in Chapters 4, 11, and 13.)
Tending \lour Ftou/ers
Knowing when you’re most prone to the symptoms of your original problems re-sprouting, is one thing. But knowing how to troubleshoot problems and prevent weeds from growing back, is another thing altogether.
The techniques, behavioural exercises, and experiments that helped you to overcome your problems in the first place will probably work again. So, go back to basics. Keep challenging your negative thinking and thinking errors. Keep exposing yourself to your feared situations. If your life is in turmoil due to inevitable things like moving house, work difficulties, or ill health, try to keep to your normal routine as much as possible.
Above all, even when things are going well, water your pansies! Psychological watering Involves keeping up with your new ways of thinking and behaving, by giving yourself plenty of opportunity to consistently practice and test your new ways of living. As we mention in Chapter 13, Healthy, alternative beliefs take time to become habitual (refer to Chapter 13). Be patient with yourself and keep doing healthy things, even when you’re symptom-free.
Developing a plan for times of crisis is another good idea. Here are some examples of what you may wish to include in your plan in the event of a potential relapse:
Consider seeing your GP or psychiatrist to determine whether you need to go on medication for a while.
Talk about your feelings to someone you trust. Pick a person who you can rely on to be supportive. Seek the help of a professional if talking to a friend or family member is not enough.
Review your efforts from previous CBT work and re-use the exercises that were most effective.
Keep your lifestyle healthy and active.
Planting new Varieties
Digging out a weed (unhealthy belief and behaviour) is important, but you also need to plant a flower (healthy belief and behaviour) in its place. For example, if you notice that an old belief like ‘I have to get my boss’s approval, otherwise it proves that I’m unworthy’ resurging, dispute the belief with arguments about the logic, helpfulness, and truth of the belief. (Chapter 13 has more about disputing unhealthy beliefs.)
You also need to plant a healthy belief, such as ‘I want my boss’s approval, but I don’t have to get approval in order to be a worthwhile person’. You can strengthen the new belief by gathering arguments for the logic, helpfulness, and truth of the alternative healthy belief.
To strengthen new beliefs and behaviours further, you can devise situations that you know are likely to trigger your old unhealthy beliefs, and work at endorsing and acting according to your new beliefs instead. For example, deliberately seek your boss’s feedback on a piece of work that you know is not your best. Resist your old behaviours that arise from the unhealthy belief that ‘I must get my boss’s approval’, such as over-apologising or making excuses. Instead accept yourself for producing a less than good piece of work and take note of constructive criticism (refer to Chapter 12 for more about self-acceptance, and head to Chapter 15 for more techniques to strengthen new beliefs).
You can dig out unhealthy behavioural weeds and plant behavioural flowers in their place. For example, you may note that you drink more alcohol in the evenings as your mood lowers with the shortening days. You know that the onset of winter gets you down because you spend more time in the house. You can make the choice to stop drinking more than one glass of wine in the evening and start going to a local dance class or some other activity instead. You can also make a list of activities to do indoors, which will keep you occupied during the winter evenings.
A happy gardener’s checklist
Here are some points to help you prevent and overcome relapse. Use this checklist to stop your marigolds getting choked by bindweed.
Stay calm. Remember that setbacks are normal. Everyone has ups and downs.
Make use of setbacks. Your setbacks can show you the things that make you feel worse as well as what you can do to improve your situation. Look for preventive measures that you may have used to get better, but that you may have let slide when your symptoms reduced.
Identify triggers. A setback can give you extra information about your vulnerable areas. Use this information to plan how to deal with predictable setbacks in the future.
Use what you have learned from CBT.
Sometimes you think that a setback means that you’re never going to get fully well, or that CBT hasn’t worked for you. But if the stuff you did worked once, then chances are, the same stuff can work again. Stick with it; you’ve nothing to lose by trying.
Put things into perspective. Unfortunately, the more you’ve improved your emotional health, the worse black patches will seem in contrast. Review your improvement and try to see this contrast in a positive way – as evidence of how far you’ve come.
Be compassionate with yourself. People often get down on themselves about
Setbacks. No one is to blame. You can help yourself get back on track by seeing a setback as a problem to overcome, rather than a stick with which to beat yourself.
Remember your gains. Nothing can take your gains away from you. Even if your gains seem to have vanished, they can come back. You can take action to make this happen more quickly.
Face your fears. Don’t let yourself avoid whatever triggered your setback. You can devise further exposure exercises (refer to Chapters 11 and 15) to help you deal with the trigger more effectively next time it happens.
Set realistic goals. Occasionally, you may experience a setback because you bite off more than you can chew. Keep your exercises challenging but not overwhelming. Break bigger goals into smaller, mini-goals.
Hang on! Even if you aren’t able to get over a setback immediately, don’t give up hope. With time and effort, you can come out of the setback. Don’t hesitate to get appropriate support from friends and professionals if you think you need to. Remind yourself of times in the past when you felt as despairing and hopeless as you do now. Remind yourself of how you got out of the slump – and use the same strategies now.
Happy gardening!
Plant flowers in place of weeds, and tend those flowers to keep them hardy. Your weeds will have greater difficulty growing again where healthy flowers are thriving.
How does your garden grow?
Research shows that CBT has a better relapse-prevention rate than medication on its own or other types of therapy. This difference may be because CBT encourages you to become your own therapist. Doing behavioural and written exercises does seem to help people to stay well.
And for longer. Try to continue to be an active gardener throughout your life. Left to their own devises, most gardens become overrun with weeds. Think of maintaining the health of your psychological garden as an ongoing project.
Being a compassionate gardener
What do you do if one of your precious plants isn’t doing so well? If you notice that you’ve got blight on your prize rose, do you deprive it of food and water, or do you try to treat the disease? It’s better not to abuse or neglect the plants in your garden for failing to thrive because – if you do, they may only wilt further. You probably don’t blame the plant for ill-health, so why should you blame yourself when you relapse?
Yes, take responsibility for anything that you may be doing that’s self-defeating. And yes, accept responsibility for taking charge of your thinking, and ultimately, for engineering your own recovery. But, also take a compassionate view of yourself and your problems. Some of your unhealthy tendencies may have taken root partly due to childhood and early adulthood experiences. Others may have some biological underpinnings. Some of your problems may have arisen from a trauma. You’re not alone in having emotional problems. You’re part of the human race, and there is no reason to expect more of yourself than you do of others with regard to staying emotionally healthy.
If you take a responsible, compassionate view of setbacks, you will be more able to help yourself get well again.
You know that ‘they’ say you should talk to your plants to make them grow? Well, it may sound a bit daft, but maybe there’s something in it. Try imagining yourself as a little pot plant on your kitchen windowsill. Talk to yourself encouragingly and lovingly when you notice your leaves drooping. Give yourself the types of messages that nurture rather than deplete you.
In This Chapter
3. Do you feel very comfortable with your own and others’ bodies? Are you free from excess inhibition and body image hang-ups? Yes/No
7. Do you take your own health seriously by exercising, watching what you eat, and using moderation? Yes/No
10. Are you willing to invest a significant amount of time and money for schooling, supplies, association memberships, and equipment? Yes/No
I> Anatomy Physiology Massage (duh!)
All massage schools are not created equal. And the one you choose may play an extremely important role in your overall experience of massage. Some schools have a very grass-roots feeling, and attending them makes you feel like a part of the massage revolution as it unfolds across the globe, touching people’s spirits, as well as their bodies, in many important ways. Other schools are more interested in providing their students with a no-nonsense, technically oriented approach to massage based more strictly on a medical model.
Everybody there is making a change of some sort in their lives, which makes for a lot of very open people, ready to share themselves with you, and ready to have fun!
The laws regarding licensing can indeed be confusing, and they’re different everywhere you go, so the best advice I can give you is to do some thorough research into the regulations in your own area. Just a little accidental slip-up could turn you into an outlaw massage rogue, which would not be good for your professional reputation.
I don’t work after 8 p. m. U* I only take new clients by referral.
That’s right — in the future, as a massage therapist, others may respect you as a part of the evolving medical field, and your services may be paid for through insurance billing. This is already happening, but it may soon become more common.
After you work to establish yourself as a massage therapist, you may be at an entirely different place than you have ever experienced up to now. A good place. It’s a place that often leads to other places, as those who gain success turn around and teach their skills to others in a variety of ways.
Many massage therapists compound their success by turning to teaching at massage schools, at weekend workshops, and in books and videos that they create for other massage therapists. Some massage therapists even go on to become consultants, speakers, and sought-after health experts.-90.jpg)
In This Chapter
The Problem: A 1,230-foot cable stretches from the starting point of a ski lift to the top of a tower that sits on the highest point of a ski slope (see Figure 18-3). The mountain is 1,150 feet tall, and the starting point of the ski lift is 270 feet from a point directly under the tower. How tall is the tower?
LAiV When you determine the combined height of the tower and the top of the ski slope, you can subtract the height of the ski slope from that combined height to get the height of the tower. The hypotenuse of this right triangle is the cable carrying the skiers. Using A2 + B2 = C2, Let A Represent the total height, B Represent the horizontal distance, and C Represent the length of the cable. Your equation becomes A2 + 2702 = 1,2302. Simplifying, you get A2 + 72,900 = 1,512,900. Subtracting 72,900 from each side, A2 = 1,440,000. The positive square root of 1,440,000 is 1,200. Because the mountain is 1,150 feet tall, the tower must be 1,200 – 1,150 = 50 feet tall.
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Figure 18-8:
The Problem: Shrimper Stanley is 10 miles from shore in his boat. The store where he sells his daily catch of shrimp is 60 miles down the coast and X Miles inland. Stanley lands his boat 24 miles down the coast and bicycles directly to the store. His boat moves at 13 miles per hour, and he bicycles at 15 miles per hour. If the trip from his boat to the store takes a total of 5 hours, then how far is it from the shore to the store? Figure 18-9 shows you the layout of the distances and speeds.
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Now, determining the sums of the diagonal distances (hypotenuses):
After 5 seconds, at a rate of 2 feet per second, the boat has moved 10 feet. Using the height of the dock as 8 feet and the distance from the dock as 10 feet, then 82 + 102 = 164 = c2. The value of C (length of the rope) is about 12.81 feet. Divide that by 5 seconds, and the rope is playing out (being pulled out) at an average rate of about 2.56 feet per second.
^ Finding out what healing therapies are all about ^ Exploring different types of healing ^ Discovering what healing therapies can be good for ^ Examining the evidence
^ Knowing what to expect in a typical healing session ^ Knowing how to find safe and effective healers
A (Very) Brief History of Healing
The Victorian era witnessed a great surge of interest in the occult, spiritualism, and the paranormal. During this time, mediums and spiritualists were often called on to give direct or absent healing at a distance.
Several different types of healing are used in different healing therapies. The following list outlines the main types:
Crystals are believed to emanate vibrational frequencies that resonate with different organs of the body and the body’s energetic centres, or Chakras.
The healer channels healing via hands held on, or just away from, the body. You do not need to have any particular faith or belief to receive this healing and it may also be used for absent healing.
Quite a large number of studies have been done demonstrating lowered blood pressure and decreased stress and anxiety after therapeutic touch. However, some argue that these changes were due to placebo rather than any specific healing effect and two review studies have found no real evidence of any therapeutic effect.
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