How to Overcome Self-Defeating Thoughts and Actions




Rebecca Gladding, M.D., is an author of the new book, You Are Not Your Brain, co-written with Jeffrey M. Schwartz, M.D. Dr. Gladding is a clinical instructor and attending psychiatrist at UCLA who was featured in A&E's critically acclaimed series Obsessed. She is an expert in anxiety, depression, mindfulness and the Four Steps.

 

You Are Not Your Brain

Using the Four Steps to Overcome Negative Thoughts and Unhealthy Actions

Published on June 8, 2011 by Rebecca Gladding, M.D.

When I talk to people about a central idea in our book - that you are not your brain - they tend to respond in one of two ways. The first is with some version of "Of course I am not my brain! That's obvious." The other response often is one of confusion, something along the lines of, "Well, if I am not these thoughts, impulses, urges and actions, who am I? Doesn't my brain define me?"

Interestingly, these responses mirror the current debate raging in the neuroscience community on this very topic. Some scientists believe that there is nothing but the brain - that it controls what we think, who we are, our values and actions. To them, the mind simply does not exist. Rather, it is the brain that changes itself, not us or what we do. The other camp, which my mentor and co-author Dr. Jeffrey Schwartz and I are part of, believe that the mind is intimately connected with, and can exert some pretty powerful effects on, the brain.

In short, we believe that people are so much more than what their brain is trying to tell them they are and that the brain often gets in the way of our true, long-term goals and values in life (i.e., our true self).

While passionate academic disagreement can be quite interesting, and even entertaining at times, it doesn't help us much in our everyday lives. So, do we have the power to influence our brains or not? Obviously, Dr. Schwartz and I believe that we do have the ability to harness the power of focused attention to change our brain in ways that are healthy and beneficial to us. Even more to the point, many of the thoughts, impulses, urges and sensations we experience do not reflect who we are or the life we want to live. These false missives are not true representations of us, but rather are inaccurate, and highly deceptive, brain messages. 

Recognizing this fact, you likely will rapidly begin to see all the places where your brain is less than helpful - where it is working against you and your true goals and values in life. When you think about the brain and how it is structured, it makes sense. The brain's chief job is to keep you alive, so it tends to operate in a survival of the fittest mode. While that's certainly imperative when dealing with life-threatening situations, that approach does not help us much in society or in our relationships. Rather, it often gets us into trouble and cause us to act in ways we later regret.

In short, the brain likely has run your life in a less than optimal way and caused you to experience one or more of the following at some point in your life: anxiety, self-doubt, perfectionism, behaving in ways or engaging in habits that are not good for you (e.g., over-texting, over-analyzing, stress eating, drinking too much and so on), ignoring your true self and/or wholeheartedly believing the stream of negative thoughts coursing through your head.

Accepting that your brain often does not make your long-term goals a priority, the solution becomes clear: you need to learn how to activate your mind so that it can help sculpt your brain to work for, rather than against, you. One great way to learn how to do this is with the Four

Steps.

What are the Four Steps?

Originally developed by Dr. Schwartz to help people with obsessive-compulsive disorder (OCD), the Four Steps is a powerful, yet easy-to-follow method that teaches you how to enhance your awareness and focus your attention in the ways you want to, while simultaneously changing your brain in positive and healthy ways.

Together, Dr. Schwartz and I have spent the last few years revising and enhancing the Four Steps to ensure that they apply to all kinds of deceptive brain messages and situations in life, not just OCD. Here is a synopsis of each of the steps:

Step 1: Relabel.

Identify the deceptive brain messages (i.e., the unhelpful thoughts, urges, desires and impulses) and the uncomfortable sensations; call them what they really are.

Step 2: Reframe.

Change your perception of the importance of the deceptive brain messages; say why these thoughts, urges, and impulses keep bother you (it's not me, it's just the brain).

Step 3: Refocus.

Direct your attention toward an activity or mental process that is wholesome and productive - even while the false and deceptive urges, thoughts, impulses, and sensations are still present and bothering you.

Step 4: Revalue.

Clearly see the thoughts, urges, and impulses for what they are: sensations caused by deceptive brain messages that are not true and that have little to no value.

How could you use the Four Steps if you check your email every 5 minutes when you are at home on the weekend (and it is not necessary to check at all)?

Step 1: Relabel - say what is happening, "Oh, I am having the urge to check email again."

Step 2: Reframe - remind yourself why this is bothering you. Say, "I am having the urge to check email again because it gives me a rush when there's something in the inbox...it feels good. Checking my messages also decreases my anxiety that I might be missing out on something." Remind yourself that you are not your brain and you do not have to respond to every impulse your brain generates.

Step 3: Refocus - go for a walk, call a friend, play a game. Do something that will interest you and is fun. It's the weekend after all.

Step 4: Revalue - recognize that this urge to check email is nothing more than the feeling of a deceptive brain message. It is not something that needs to be taken seriously or paid attention to. In fact, giving into this urge just makes the underlying brain circuitry stronger. The more you check, the more frequent and intense the urges will become. So, dismiss this deceptive brain message and go do something healthy and productive instead.

The key to the Four Steps is practice. You literally need to keep using the Four Steps over and over. By becoming more aware of what is happening and learning how to Refocus your attention in healthier and productive ways whenever a deceptive brain message strikes, you teach your brain new, beneficial responses. With time, you will learn how to place your attention where you want it to go, not where your brain is beckoning you to follow.

Book Review: Jeffrey Schwartz’s “You Are Not Your Brain”

by Guinevere, June 15, 2011

 

 

Leo DiCaprio as the obsession-driven Howard Hughes.

So here’s an interesting story about the work of Jeffrey Schwartz, M.D., a psychiatrist who studies neuroplasticity and mindfulness, and who specializes in treating obsessive-compulsive disorder (OCD) with cognitive-behavioral techniques. Schwartz was apparently a consultant to Leonardo DiCaprio when Leo was studying to play Howard Hughes in Martin Scorsese’s 2004 film, The Aviator. Hughes was notoriously debilitated by severe OCD, which eventually rendered him a recluse in later life. And to play the part, DiCaprio made the choice to “let his own mild OCD get worse,” Schwartz has said. Schwartz said

By playing Hughes and giving into his own compulsions, Leo induced a more severe form of OCD in himself. There is strong experimental evidence this kind of switch can happen to actors who concentrate so hard on playing OCD sufferers.

It apparently took DiCaprio three or four months to recover from his self-induced OCD.

When actors play a role, Schwartz has said, they can alter the nature of their brain-chemistry—it’s been documented in the lab. Schwartz has taken that idea and turned it on its head: if people can successfully choose to induce illness in themselves, then people should also be able to choose to get better.

Which is really good news for addicts. Because we adopted a bunch of behaviors and choices that led us into our illness; and it would seem Schwartz is saying we can get back out the same way we came—by making a bunch of different choices.

Schwartz’s new book, written with his colleague, Rebecca Gladding, M.D., is You Are Not Your Brain: The 4-Step Solution for Changing Bad Habits. It’s a kind of sequel to Brain Lock, his popular manual for controlling OCD. In You Are Not Your Brain he aims to show how people with any kind of debilitating compulsion or habit can change their neurochemistry by changing their actions and thoughts—thoughts being a kind of action, according to the practices of mindfulness which Schwartz espouses.

I love the idea of neuroplasticity—which is essentially the idea that the body’s neurology is not set in stone. When I was a kid, I was taught that we were born with a certain number of brain cells, and that if they somehow got damaged or broken, we’d be out-of-luck—those cells would never grow back, and those electrical connections would be forever severed. Scientists like Schwartz are proving that, in fact, the human neurological system is smarter and more resilient than we thought it was, and that it can not only carve out new pathways but that we exert a certain amount of control over our own neurology through the “force of will” or, as I prefer to understand it, through “mind.”

Schwartz makes the critical distinction that “mind” and “brain” are not one and the same:

The brain receives inputs and generates the passive side of experience, whereas the mind is active, focusing attention, and making decisions. … In other words, the brain does not incorporate your true self or Wise Advocate into its processes, but merely reacts to its environment in habitual, automatic ways.

Schwartz introduces the idea of the “Wise Advocate” (another way of thinking of higher power) very early in the book. He talks about “sculpting” the brain you want to have by using your will, but it becomes clear that in practice he advocates tapping into the wisdom of a power greater (wiser, smarter, more dependable and less selfish, however you want to say it) than self-will. So following his program becomes a process more of self-discovery than self-creation. To my mind, the latter would be more selfish and self-serving, unless healing is the primary motivation.

How can this book help people with addiction?

I’m a relative newcomer to sobriety, but I’ve experienced recovery as a process of finding out who I really am after a lifetime (or half a lifetime) of spending much of my time and energy pretending to be someone in order to make other people happy, which never worked anyway.

“Deceptive brain messages get stronger the more you ignore, deny, and neglect your true self,” Schwartz writes. To me this is just another way of saying that the more I persist in insane behavior (which does not always have to include drinking, using drugs, gambling, overeating, or starving ourselves—it can include, for example, compulsively taking responsibility for other people’s feelings), the more I lose any chance of finding out who I really am—and the more disconnected from my higher power I become. The more I foster spiritual weakness. The sicker I remain. However you want to say it.

Recovery, for Schwartz and Gladding, is all about taking “contrary action,” including changing our thoughts about ourselves. It’s not rocket-science, and it seems to me that, having been in and out of therapy since my mid-20s, I’ve heard his four steps before (Relabel, Reframe, Refocus, and Revalue). Which is just to say that it’s commonsensical and reliable stuff. It’s also to say that it harmonizes with the ways I’ve seen countless people recover from addictions just as debilitating as Howard Hughes’s OCD, perhaps more so. We take action—“contrary action,” as they say in the rooms. Action that counters what we’d feeeel like doing, but that we believe (based upon the experience of trusted others) will benefit us.

Schwartz’s practices also rely a great deal on mindfulness, which is arrived at through meditation (Step 11). I’m all for any practice that gets me to live more inside the present moment. My experience is, meditation is a tool to counter any kind of obsession, addictive or otherwise. Studies also show that meditation and prayer, if practiced diligently and long enough, can permanantly decrease fear and sadness, and make us smarter and more compassionate. The practice of it has radically changed my own life. 

OCD Trouble: Shift the Brain Into Manual Mode

When the "Brain Lock" OCD-disordered neural circuit hijacks the brain's natural, automatic gearbox's ability to shift its focus away from ceaseless obssessions, then's the time to overide the automatic gearbox with Dr. Jeffrey Schwartz's "manual" brain-shift.

Here's the condensed owner's manual for this four-step brain-shift:

Step 1: Relabel
Recognize that the intrusive obsessive thoughts and urges are the result of OCD. You don't want to do this in a merely superficial way; rather, you must work to gain a deep understanding that the feeling that is so bothersome at the moment is an obsessive feeling or a compulsive urge. To do so, it is important to increase your mindful awareness that these intrusive thoughts and urges are symptoms of a medical disorder.

Step 2: Reattribute
Realize that the intensity and intrusiveness of the thought or urge is caused by OCD; it is probably related to a biochemical imbalance in the brain. "It's not me -- it's my OCD." That is the battle cry. It's a reminder that OCD thoughts and urges are not meaningful, that they are false messages from the brain. Self-directed behavior therapy lets you gain a deeper understanding of this truth.

Step 3: Refocus
Work around the OCD thoughts by focusing your attention on something else, at least for a few minutes: Do another behavior. The Refocus step is where the real work is done. In the beginning, you may think of it as the "no pain, no gain" step. Mental exercise is like a physical workout. In Refocusing, you have work to do: You must shift the gears yourself. With effort and focused mindfulness, you are going to do what the caudate nucleus normally does easily and automatically, which is to let you know when to switch to another behavior.

Start the process of Refocusing by refusing to take the obsessive-compulsive symptoms at face value. Say to yourself, "I'm experiencing a symptom of OCD. I need to do another behavior." The goal of treatment is to stop responding to the OCD symptoms while acknowledging that, for the short term, these uncomfortable feelings will continue to bother you. You begin to "work around" them by doing another behavior. You learn that even though the OCD feeling is there, it doesn't have to control what you do. You make the decision about what you're going to do, rather than respond to OCD thoughts and urges as a robot would. By Refocusing, you reclaim your decision-making power. Those biochemical glitches in your brain are no longer running the show.

Step 4: Revalue

Do not take the OCD thought at face value. It is not significant in itself. The combined effect of these three steps is much greater than the sum of their individual parts. The process of Relabeling and Reattributing intensifies the learning that takes place during the hard work of Refocusing. As a result, you begin to Revalue those thoughts and urges that, before behavior therapy, would invariably lead you to perform compulsive behaviors. After adequate training in the first three steps, you are able in time to place a much lower value on the OCD thoughts and urges.

We who have OCD must learn to train our minds not to take intruding feelings at face value. We have to learn that these feelings mislead us. In a gradual but tempered way, we're going to change our responses to the feelings and resist them. We have a new view of the truth. In this way, we gain new insights into the truth. We learn that even persistent, intrusive feelings are transient and impermanent and will recede if not acted on. And, of course, we always remember that these feelings tend to intensify and overwhelm us when we give in to them. We must learn to recognize the urge for what it is -- and to resist it. In the course of performing this Four-Step Method of behavioral self-treatment, we are laying the foundation for building true personal mastery and the art of self-command. Through constructive resistance to OCD feelings and urges, we increase our self-esteem and experience a sense of freedom. Our ability to make conscious, self-directed choices is enhanced.