Welcome to Awareness Counseling
Elle Garfield, LMSW

Yoga and CBT

Jane's Story
Jane (not her real name) woke up too early most mornings. Fear gripped her as her eyes popped open. “Oh, no not this awful feeling again!” “I’ll never get better.” These were her first thoughts although she was more aware of the feelings that overwhelmed her.

She could feel her muscles start to tense up and she felt her stomach clench too. As she forced herself to get up out of bed she knew the nausea she was feeling would keep her from wanting to eat any breakfast. And after months of struggling with feelings of worry and anxiety she was at her lowest weight ever. How would she be able to get herself to work feeling this way? When the phone rang she dreaded the thought of telling the person on the other end she was having yet another bad day. Maybe I just won’t answer it and wait until I feel better to talk to anyone.

Unsure of what to do next and desperate to feel better she went on her computer to look up any new promising treatments for anxiety. Several hours later she had spent hundreds of dollars on a new “miracle” treatment for anxiety and had called in sick to work. She went back to bed wanting to put the covers over her head waiting for her mail order package to arrive the next day. One of many treatments she had tried before with little success.

What Helps?

Many people that experience anxiety or fear don’t have a clear idea of where their fear is coming from. They are aware of how they feel, what their symptoms are and how it is limiting their lives but they often don’t know what is fueling their fear. They are suffering and they just want those awful feelings to go away. It’s no wonder a quick fix and flashy ads for anxiety treatments are so appealing.

According to the National Institute of Mental Health (part to the U.S. Dept. of Health), “Cognitive-behavioral therapy (CBT) is very useful in treating anxiety disorders. The cognitive part helps people change the thinking patterns that support their fears, and the behavioral part helps people change the way they react to anxiety-provoking situations.” Other information from this site includes: “Often people believe that they have “failed” at treatment or that the treatment didn’t work for them when, in fact, it was not given for an adequate length of time or was administered incorrectly.”

How does CBT help change thinking patterns?
In CBT you become skilled at recognizing distortions in your thoughts so that you are able to let go of beliefs that are leading to anxiety. As you increase your understanding of what’s causing your anxiety you are able address your discomfort at the level of where it starts. That combined with changing behaviors to reinforce your new understanding is a powerful combination to help change your perspective which leads to a change in how you feel about yourself and the world.

Where Does Yoga Fit?
This description of CBT reminds me of what we do in yoga. We gain knowledge of the nature of our minds and are encouraged by our teachers not to take the fluctuations of the mind so seriously. As we are gaining this knowledge listening to the teacher share the experience of yoga we also have the experience of being in our bodies as we pay attention to the breath. Our awareness comes to the present moment and we notice there is more than the information that our thinking gives us. We are informed by the sensations in our bodies. Our feelings are a rich  (somewhat unwelcome) source of data about our true selves. Sometimes we are even lucky enough to see the error in our thinking when are bodies are able to do something we did not believe we could do. We often have an experience that “all is well” in this moment informing our mind that there is more than all that frantic activity. The yogis call this sat chit ananda, the intelligent awareness of bliss.

In yoga there is a term called “monkey mind” to describe the wild nature of our thoughts. Our thoughts seem to come from nowhere. We wake up in the morning and enter into waking consciousness. Our thinking mind jumps from one thought to the next. When we don’t notice our thoughts our tendency is to believe they are accurate. But what happens when our perceptions are off? If you have ever experienced anxiety you may have experienced some or all of these common cognitive distortions:

All-or-nothing thinking: You see things in black and white categories. If your performance falls short of perfect, you see yourself as a total failure.

Overgeneralization: You see a single negative event as a never-ending pattern of defeat.

Mental filter: You pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened, like the drop of ink that discolors the entire beaker of water.

Disqualifying the positive: You reject positive experiences by insisting they "don't count" for some reason or other. You maintain a negative belief that is contradicted by your everyday experiences.

Jumping to conclusions: You make a negative interpretation even though there are no definite facts that convincingly support your conclusion.

Mind reading: You arbitrarily conclude that someone is reacting negatively to you and don't bother to check it out.

The Fortune Teller Error: You anticipate that things will turn out badly and feel convinced that your prediction is an already-established fact.

Magnification (catastrophizing) or minimization: You exaggerate the importance of things (such as your goof-up or someone else's achievement), or you inappropriately shrink things until they appear tiny (your own desirable qualities or the other fellow's imperfections). This is also called the "binocular trick."

Emotional reasoning: You assume that your negative emotions necessarily reflect the way things really are: "I feel it, therefore it must be true."

Should statements: You try to motivate yourself with shoulds and shouldn'ts, as if you had to be whipped and punished before you could be expected to do anything. "Musts" and "oughts" are also offenders. The emotional consequence is guilt. When you direct should statements toward others, you feel anger, frustration, and resentment.

Labeling and mislabeling: This is an extreme form of overgeneralization. Instead of describing your error, you attach a negative label to yourself: "I'm a loser." When someone else's behavior rubs you the wrong way, you attach a negative label to him, "He's a damn louse." Mislabeling involves describing an event with language that is highly colored and emotionally loaded.

Personalization: You see yourself as the cause of some negative external event for which, in fact, you were not primarily responsible.

From: Burns, David D., MD. 1989. The Feeling Good Handbook. New York: William Morrow and Company, Inc.
Do you recognize any of these distortions in your own thinking?
This list is often used in CBT to help clients recognize patterns of negative thinking so that they can confront their beliefs; more easily letting go of beliefs that lead to self defeating behavior.

Monkey Mind
The ancient yogis also recognized the minds tendency to distort reality but they seemed more concerned with process than the content. Yoga teaches us that the mind can act like a monkey that has been bit by a scorpion. In this state the mind is just reacting as the mind jumps from one thought to the next unaware of misinformation it is acting out of. The result of a mind jumping from one thought to another is that it blocks yoga. Yoga literally means union, joining with the unchanging aspect of reality.  The practice of mindfulness and yoga helps us to develop a witness consciousness, in essence, training the mind to not take so seriously the frantic escapades of the monkey mind.  As we develop this witness consciousness our view expands, we see the distortions as they are and we are able to experience our connection to the unchanging, ever present, absolute nature inside of us all. We begin to feel more grounded and connected to our source.  We more easily let go of these distortions as we see them for what they truly are, lies. As we do our thinking has less and less power to disturb our sense of peace. We experience sat chit ananda.

Yes, but...
If you are thinking, “Yes, but won’t I have to keep feeling these uncomfortable feelings while I’m learning to “notice” these thought patterns. I just want these feelings to go away and never come back!” You are not alone. Most people just want to get rid of uncomfortable, even painful feelings. And in some cases doctors do recommend medication to help relieve the symptoms of anxiety. What I have found in my work as a psychotherapist and yoga teacher and in my own meditation practice is that when we are able to stop reacting and wait for the monkey mind to quiet we open ourselves up to a universe of possibilities that none of us wants to miss out on.  When we just get rid of the symptoms we cut off the opportunity to experience yoga, our connection to everything.

Jane’s recovery from anxiety didn’t happen overnight.  She was able to find a therapist who she trusted and felt comfortable with. Her mindfulness based cognitive behavioral therapist was able to help Jane learn the skills she needed to witness the fluctuating states of her mind without reacting to them. Jane began to understand that she could face her feelings and move through them. With more awareness, Jane’s “scary” thoughts didn’t rule her behavior.  She put more emphasis on what was really going on in the present moment and how she felt. Jane became more and more interested in meditation and yoga as her symptoms began to slowly improve.  Her confidence and freedom grew as she learned to take loving care of herself by making healthier choices, getting support and accepting her feelings more and more.

Wanting to turn off painful, anxious feelings is normal and understandable but not very effective or productive. Ask yourself what are the thoughts, patterns of thoughts and beliefs that lead to anxious feelings? See if you can pay closer attention to your thoughts and patterns of thoughts. Paying closer attention will shine a light on any distorted thoughts and will help develop a witness consciousness that can make it easier to let go of the thoughts that are not accurate and allows you to see yourself more clearly. If this feels too overwhelming seek the help of a professional specially trained in CBT and mindfulness or yoga to help you.  Anxiety that becomes debilitating usually builds over time. Addressing patterns and beliefs that have taken years and even generations to develop won’t change over night. Learning to tame a monkey mind takes time and skill but the freedom and confidence gained will be worth the effort.

Contact: Elle Garfield, ACSW

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