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What is a set back? A set back is when things don’t go at the pace or direction we want them to go. A set back is an event or situation that causes us to think we are no longer going forward, and maybe instead going backward. This can be scary. Yet set backs are universal, and common, so knowing about them can help us be prepared.

Many people set goals, or New Year’s resolutions, at the beginning of a year. It seems an auspicious time for a fresh start and breaking old “bad” habits or creating new “good” habits. Some people do this with cognitive behavior therapy, CBT, a method used all over the world for understanding one’s own mind and habits. This method has proven to be so effective that some refer to it as “the gold standard of psychotherapy”.

Isaac had moved from California to Maine, and in so doing had gained weight. This lead to significant health complications that were interfering with his life. He set some goals for himself, at the start of the New Year, to prioritize his overall health. After following a new set of habits, Isaac found himself in a set back. He twisted his ankle walking on some ice. He stopped going to the gym, and even when his ankle was strong again, he couldn’t seem to get himself to return. Feeling depressed, he turned to CBT.

When learning the theoretical framework of CBT, set backs are included, so that they can be consciously addressed should they occur. “Set backs are a normal part of getting better” as Dr. Judith Beck writes in her book Cognitive Behavior Therapy. A set back from this perspective then is simply another opportunity to identify and question our stressful thoughts. When Isaac’s set back occurred, he was able to identify a stream of automatic negative thoughts. These included “getting healthy in a cold climate is too hard” and “I can’t do this”.

When a set back occurs, we also find out what we are thinking about the pace of change. We might identify such automatic negative thoughts as, “I should be farther along by now” or “I’m never going to recover”. We might be afraid we will believe all of our stressful thoughts again. (Like we did before we learned CBT.) Yet once we have done some CBT, and we understand our minds better, we simply can’t believe everything we think any more. Therefore, we can be assured that we can’t actually go all the way back, that the pain won’t be as acute, because the healing has already started. We might have gone two steps forward and one step backwards, but that is still one step forward.

So, knowing that pace is personal and that others have set backs too, we might notice self-compassion. Knowing that each person has their own pace, that there is no “right” pace, and that others have set backs too, we don’t feel as bad, we don’t feel so alone and separate. Feeling connected can give us the courage to get help again.

This is just what Isaac decided.  He realized that he was not going all the way back to the beginning for two reasons. The first and primary reason was because he was doing CBT. The second reason was because still had a gym membership. He remembered that there was always a staff member on the gym floor available for assistance. Isaac decided to speak to the gym staff since they had probably seen other people have set backs and to ask them for guidance on developing an exercise plan that was tailored to a pace which was a good fit for him.

Isaac had become aware of his thoughts and how his mind works. There is a huge difference between thoughts going through our minds and being aware of thoughts going through our mind. Isaac realized he had been believing he should be progressing at a faster pace. He became aware that he was confusing reality with a narrative his thoughts had created.

If you have set a goal for yourself, choose a method that you can believe in. If you know that you are using a method that works, then even if you doubt yourself, you can have confidence in the method. I am partial to CBT. So, even when I don’t believe in myself, I believe in CBT. I can remember that CBT works and when an event occurs that feels like a set back, this is time to do more CBT. Other people have done it before with their own set backs, and their own pace, and they have healed. CBT is called the “gold standard” because it works so well. In some significant way, of course, healing is determined by how we handle our setbacks. Life does not progress and grow in a straight line.

David, D., Cristea, I., & Hofmann, S.G. (2018). Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy. Frontiers in Psychiatry. Vol 9, pg. 4.

Beck, J. S. (2021). Cognitive Behavior Therapy; Basics and Beyond, Third Edition. New York, NY: The Guilford Press.