The idea of being powerless had always been quite painful to Leo. He had come to my psychotherapy practice because I use cognitive behavior therapy, and he knew that there was significant evidence for its efficacy. Leo was a “numbers guy” as he called himself and worked in finance in New York and London.
The usual course of treatment in CBT involves an initial emphasis on identifying and modifying stressful automatic thoughts. Psychotherapists teach patients to identify these cognitions (thoughts) that are closest to conscious awareness and then gain distance from them by learning that just because they believe something doesn’t necessarily mean it is true. Thereafter learning to consider changing their thinking to be more reality based, as this helps them feel better and make progress towards their goal.
An important feature of CBT is showing people how their thinking affects their reactions using their own examples.
So, first, to make sure that Leo could verbalize his understanding of the cognitive model, I asked him, “Can you tell me in your own words about the connection between thoughts and feelings?”
“Well,” he said, “My thoughts affect how I feel.”
“Exactly,” I said. “So, what I’d like to do now, if you agree, is to talk for a few minutes about a time in the past few days when you noticed your mood change? In other words, when you might have been aware that you had become upset?”
Leo began talking about his girlfriend. He hoped to marry her, but lately things had been shaky.
“Last night,” he said. “We were at home and she was stressed about her mother. She shells up when she’s in a doom and gloom mood.”
“How did that make you feel, in your body. How did you react?” I asked.
“Frustrated. Incredibly frustrated,” he answered. “My hands clench and I feel really tense.”
“And what was going through your mind at the time?”
“I don’t remember exactly,” said Leo.
“Can you imagine yourself back in the apartment right now? Can you imagine the two of you there? Describe the scene for me as if it’s happening right now.”
“Well, I’m sitting at the dinning room table, and she’s on the couch. The dog is next to her.”
“And how are you feeling as you look at her?”
“Frustrated. And kind of sad.”
“What’s going through your mind?”
“That I can’t help her! She should understand that I’m trying to help her!”
“She should understand you?” I asked.
“Yes!”
“Shall we question that thought?” I asked.
“Yeah, OK,” he said.
I wrote it down and asked him, “When you believe this thought, ‘she should understand me’, what happens?”
“I feel frustrated,” he answered quietly. “Discouraged. I want us to be happy.”
“If you never had this thought again, ‘she should understand me’, how would you be different in this situation?” I asked Leo.
“I wouldn’t get down on myself...I’d be happier...I wouldn’t be concerned with her interpretation of my motives...I’d be more present.”
“Wow,” I said. “That sounds really good. Shall we consider an alternative thought? Like the more accurate one, that ‘she shouldn’t understand you’. She shouldn’t understand you, in that situation, simply because she doesn’t.”
“Yeah, that feels good and more true,” said Leo, “She knows I love her. Meaning...she doesn’t have to understand me to feel loved by me.”
“What about ‘I should understand me’?”
“Yeah, totally. I should understand myself! I’m trying to fix things for her and she doesn’t want that at all. When I try to tell her what to do with her mother, she feels like I’m talking down to her. She hates that. So if I understand me, I notice that I’m uncomfortable when she suffers. I really do love her. And she really can figure out things! I could try to listen, and be supportive, instead of telling her what to do.”
Leo felt better. He had found what he could control, where his real power was to be found; inside himself. He learned that with CBT he had power over his outlook and that determined his experience of his life.
Somehow we’ve come to believe that if we admit we don’t have all of the answers, we seem powerless. Yet no one has all of the answers. Powerful people know when to seek assistance. Asking for help is a power move.
Eckhart Tolle says that, “True power is within and is available to you now.”
