Seph has a passion for positive psychology. Seph strongly believes that we can deal with most of the absurdities of life without the use of pharmaceutical drugs and that doctors should prescribe walking or running and a plant-based diet instead of Prozac.
The Positive Psychology toolkit is a science-based, online platform containing 170+ exercises, activities, interventions, questionnaires, assessments and scales.
What Is Automatic Thinking?
Automatic thinking refers to the automatic thoughts that stem from the beliefs people hold about themselves, such as those beliefs that are of interest to rational-emotive behavior therapy and other cognitive-behavioral therapies (Soflau & David, 2017). Automatic thoughts can be considered “surface-level, non-volitional, stream-of-consciousness cognitions” that “can appear in the form of descriptions, inferences, or situation-specific evaluations”.
As the name indicates, these automatic thoughts cannot be directly controlled by people, since they are reflexive reactions based on the beliefs people hold about themselves. People can indirectly control these thoughts, though, by challenging the beliefs that lead to them.
Relevant research into automatic thinking began with Aaron Beck’s research into how negative automatic thoughts affected the development of depression (Beck et al., 1979). Before long, researchers decided that positive automatic thoughts were also important to study, and particularly the relationship between positive automatic thoughts and negative automatic thoughts (Ingram & Wisnicki, 1988). There are a variety of consequences to being disposed towards negative automatic thoughts rather than positive automatic thoughts.
For example, in people with depression and HIV/AIDS, negative automatic thoughts are associated with depressive symptoms, and vice-versa (Riley et al., 2017). In athletes, negative automatic thoughts can lead to burnout (Chang et al., 2017). Finally, in a sample of university students without any shared physical or mental health conditions, automatic thoughts had significant impacts on mental health and self-esteem, with negative automatic thoughts leading to more mental health symptoms and decreased levels of self-esteem (Hicdurmaz et al., 2017).
Our Cognitive Bias: Construction Of The Self-Concept
Self-concept refers to how one perceives themselves, their past experiences, their abilities, their prospects for the future, and any other aspect of the self. Aaron Beck’s cognitive triad, discussed below, deals with self-concept and the construction of the self. The basic idea of how our self-concepts and cognitive biases affect our lives has to do with automatic thoughts.
For example, someone with a negative “self-referential schema” is more likely to take things personally, leading to automatic thoughts like “People are not talking to me because I am an unlikable person”, rather than exploring other possibilities (Disner et al., 2017). A negative self-referential schema can also lead to increased severity of depression symptoms. Most importantly, a negative self-concept can lead to an unending cycle of negative thoughts.
This is because people with negative self-referential schemas exhibit an attentional bias. For example, when asked to decide whether an adjective is self-referential or not, people with depression are more likely to endorse negative adjectives than healthy controls, and they show an attentional bias by being quicker to endorse negative adjectives and quicker to reject positive adjectives than healthy controls (Disner et al., 2017). In turn, being likelier to endorse negative adjectives is correlated with longer “retrospectively reported” depressive episodes, demonstrating the cycle of negativity.
Aaron Beck’s Cognitive Triad
According to Beck et al. (1979),
“[the] cognitive triad consists of three major cognitive patterns that induce the patient to regard himself, his future, and his experiences in an idiosyncratic manner”.
According to Beck’s cognitive triad, someone who is depressed will automatically have a negative view of themselves, their experiences (that is, the things that the world around them causes to happen to them), and their future. According to this model, “the other signs and symptoms of the depressive syndrome” are “consequences of the activation of the negative cognitive patterns”.
This is because a depressed person:
“tends to perceive his present, his future, and the outside world (the cognitive triad) in a negative way and consequently shows a biased interpretation of his experiences, negative expectancies as to the probable success of anything he undertakes, and a massive amount of self-criticism” (Beck et al., 1979).
In other words, people who are depressed have a negative view of themselves and their lives, and these negative views lead to (further) symptoms of depression. These symptoms of depression then lead to people having a negative view of themselves and their lives, and as discussed in the previous section, this also leads to a cycle of negativity.
50+ Examples of Positive & Negative Automatic Thoughts
So how do automatic thoughts actually present themselves? Since automatic thinking research began with negative thoughts, let us begin with negative automatic thoughts. According to the Automatic Thoughts Questionnaire (ATQ-30) developed by Hollon & Kendall (1980), some examples of negative automatic thoughts include:
“I feel like I’m up against the world.”
“I’m no good.”
“Why can’t I ever succeed?”
“No one understands me.”
“I’ve let people down.”
“I don’t think I can go on.”
“I wish I were a better person.”
“I’m so weak.”
“My life’s not going the way I want it to.”
“I’m so disappointed in myself.”
“Nothing feels good anymore.”
“I can’t stand this anymore.”
“I can’t get started.”
“What’s wrong with me?”
“I wish I were somewhere else.”
“I can’t get things together.”
“I hate myself.”
“Wish I could just disappear.”
“What’s the matter with me?”
“I’m a loser.”
“My life is a mess.”
“I’m a failure.”
“I’ll never make it.”
“I feel so helpless.”
“Something has to change.”
“There must be something wrong with me.”
“My future is bleak.”
“It’s just not worth it.”
“I can’t finish anything.”
According to Ingram & Wisnicki (1988), some examples of positive automatic thoughts include:
“I am respected by my peers.”
“I have a good sense of humor.”
“My future looks bright.”
“I will be successful.”
“I’m fun to be with.”
“I am in a great mood.”
“There are many people who care about me.”
“I’m proud of my accomplishments.”
“I will finish what I start.”
“I have many good qualities.”
“I am comfortable with life.”
“I have a good way with others.”
“I am a lucky person.”
“I have friends who support me.”
“Life is exciting.”
“I enjoy a challenge.”
“My social life is terrific.”
“There’s nothing to worry about.”
“I’m so relaxed.”
“My life is running smoothly.”
“I’m happy with the way I look.”
“I take good care of myself.”
“I deserve the best in life.”
“Bad days are rare.”
“I have many useful qualities.”
“There is no problem that is hopeless.”
“I won’t give up.”
“I state my opinions with confidence.”
“My life keeps getting better.”
“Today I’ve accomplished a lot.”
While the 30 items listed above are indeed examples of automatic thoughts, the automatic thoughts questionnaire-revised (ATQ-R) (Kendall et al., 1989), which is a measure still used as a basis for automatic thinking research (Koseki et al., 2013), lists the following ten items as examples of automatic thoughts (along with the 30 negative thoughts listed above):
“I’m proud of myself.”
“I feel fine.”
“No matter what happens, I know I’ll make it.”
“I can accomplish anything.”
“I feel good.”
“I’m warm and comfortable.”
“I feel confident I can do anything I set my mind to.”
“I feel very happy.”
“This is super!”
“I’m luckier than most people.”
Cognitive Restructuring Of Core Beliefs & Automatic Thoughts
Positive automatic thoughts can offset the negative effects of both negative automatic thoughts and stress in general.
For example, people with high levels of positive automatic thoughts are likely to respond to stress by feeling that their lives are more meaningful, while people with low levels of positive automatic thoughts are likely to respond to stress by feeling that their lives are less meaningful (Boyraz & Lightsey, 2012).
Furthermore, higher levels of positive automatic thoughts are correlated with higher levels of happiness as well (Lightsey, 1994).
This indicates that in order to have better mental health outcomes, one should reduce their negative automatic negative thoughts and increase their positive automatic thoughts, in order to have a healthier balance. This is because some negative thinking is natural, so it is not a matter of completely eliminating negative thoughts but outweighing them with positive thoughts. One way to do this is with cognitive restructuring (CR), which involves (Hope et al., 2010):
“identification of problematic cognitions known as ‘automatic thoughts'”
“identification of the cognitive distortions in the ATs”
“rational disputation of ATs with Socratic dialogue”
“development of a rational rebuttal to the ATs”
Research in CR with automatic thoughts indicates that effective CR might focus on “Negative Self-Evaluative ATs”, such as situationally-based evaluations. One example would be a situation where one’s automatic thought when faced with an uncomfortable situation might be “I won’t know what to say” (Hope et al., 2010). This is because these thoughts are easily disproved with exposure and role-playing. Another effective CR method when dealing with “other-referent ATs” (as opposed to “self-referent” ATs) is to minimize the consequences of the negative automatic thoughts, such as by asking oneself “So what if she thinks you are boring?”.
Aside from CR, research indicates that people with higher levels of dispositional mindfulness are also less likely to experience automatic negative thoughts, potentially because they can more easily let go of negative thoughts or direct their attention elsewhere (Frewen et al., 2008). That study also indicated that a mindfulness intervention derived from both mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) was effective at reducing negative thoughts. This indicates that along with positive thinking, mindfulness is another way to counteract negative automatic thinking.
5 CBT Worksheets For Challenging Negative Self-Talk & AT’s
For practical ways to challenge and dispute negative automatic thinking, one can try using one of these worksheets:
Automatic Thoughts from Therapist Aid
This is a simple worksheet which starts by offering some information about automatic thoughts and their consequences. The rest of the worksheet is split into three columns: Trigger, Automatic Thought, and New Thought, which aims to help people understand and dispute (if necessary) their own automatic thoughts. This worksheet is a great introduction to automatic thoughts.
Characteristics of Negative Automatic Thoughts
This 14-page worksheet is a deep dive into negative automatic thoughts, what causes them, how to identify them, and how to start disputing them. This worksheet is not as directly useful as others for finding replacement positive thoughts, but by helping people better understand their negative automatic thoughts it may indirectly lead to replacement positive thoughts. This is a great option for just about anyone interested in negative automatic thoughts, because it contains so much information that there is bound to be something new for everyone.
Thought/Feeling Record Worksheet
This worksheet unfortunately does not come in the form of a PDF but is valuable enough that it is worth printing out and working through anyways. This worksheet helps the user really focus in on a specific negative automatic thought and examine what triggered it as well as its consequences. Once one really understands the negative automatic thought, this worksheet helps turn negative thoughts into positive thoughts. This worksheet is excellent for someone looking to extensively examine their individual thoughts.
Positive Thought Replacement Worksheet
This worksheet simply asks one to list all the automatic negative thoughts that come to their mind, then asks them to thoughtfully come up with alternative positive thoughts they can replace the negative thoughts with. Since this worksheet does not offer information about automatic thoughts, it is a good option for someone who does not need to learn more about automatic thoughts but is simply ready to start replacing their negative thoughts with positive thoughts.
Appendix 1 Worksheets and Checklists
This 10-page worksheet, which seems to be the appendix to a book on CBT, serves as a self-directed treatment plan revolving around automatic thoughts. It includes an automatic thoughts checklist (where one can just check off automatic negative thoughts they have experienced, rather than having to generate them on their own), a “Thought Change Record” which aims to help people dispute negative thoughts, a “Schema Inventory”, where one can find out if they have any dysfunctional underlying schemas (such as “I’m stupid” or “I’m a fake”), and much more. This extensive worksheet is a great option for people who want to use self-directed CBT to deal with their automatic negative thoughts.
A Take Home Message
Negative automatic thinking not only leads to poor mental health outcomes, but it can also lead to a cycle of negativity, since certain mental health issues can lead to further negative thoughts. While these thoughts can seem impossible to avoid, one can use positive thinking to counteract these thoughts. Through CBT methods, one can even train themselves to think more positive thoughts in general.
At times, “the power of positive thinking” can sound like nothing more than an inspirational cliché. In this case, though, having healthy beliefs about oneself can lead to positive automatic thinking, which can indeed be beneficial. Most importantly, thinking positive thoughts and having positive beliefs does not cost anything, so it does not hurt to do one’s best to try.
Beck, A.T., Rush, A.J., Shaw, B.F., Emery, G. (1979). Cognitive Therapy of Depression. New York, NY: The Guilford Press
Boyraz, G., Lightsey, O.R. (2012). Can Positive Thinking Help? Positive Automatic Thoughts as Moderators of the Stress-Meaning Relationship. American Journal of Orthopsychiatry, 82(2), 267-277. doi:10.1111/j.1939-0025.2012.01150.x
Chang, K.H., Lu, F.J.H., Chyi, T., Hsu, Y.W., Chan, S.W., Wang, E.T.W. (2017). Examining the stress-burnout relationship: the mediating role of negative thoughts. PeerJ, 5(1), e4181. doi:10.7717/peerj.4181
Disner, S.G., Shumake, J.D., Beevers, C.G. (2017). Self-referential schemas and attentional bias predict severity and naturalistic course of depression symptoms. Cognition & Emotion, 31(4), 632-644. doi:10.1080/02699931.2016.1146123
Frewen, P.A., Evans, E.M., Maraj, N., Dozois, D.J.A., Partridge, K. (2008). Letting Go: Mindfulness and Negative Automatic Thinking. Cognitive Therapy and Research, 32(6), 758-774...
Every year on March 20th the world celebrates the International Day of Happiness.
Commonly known as Happiness Day, the date is set aside to promote the pursuit of happiness and acknowledge that it is also a basic human right.
Proclaimed by the United Nations General Assembly in 2012, the assembly states that the objective of Happiness Day is to be:
‘Conscious that the pursuit of happiness is a fundamental human goal’ and to recognize the ‘need for a more inclusive, equitable and balanced approach to economic growth that promotes sustainable development, poverty eradication, happiness and the well-being of all peoples’.
Created to honor Happiness Day, Happy Acts is an initiative and campaign with strong aspirations to help make the world a happier place, one happy act at a time. By inspiring happiness and a sense of community, Happy Acts uses social media to promote users to make and share small happy acts that can create a big impact.
What are Happy Acts?
Happy acts are small, thoughtful acts of kindness that we can intentionally do for others that may provide their day with a potential boost of happiness.
A happy act could simply be saying good morning to a passing stranger or offering someone to go before you in a check-out line. For more inspiration, you can download a happiness calendar at Happy Acts for a daily dose of happiness ideas to spread year-round.
To help the initiative grow and promote the spread of happiness further, Happy Acts encourages people to share their acts of kindness and thoughtful expressions on social media by using the hashtag #HappyActs. In 2017 their audience managed to create over 8.4 million impressions online, that’s a lot of smiling faces!
What are #HappyActs - YouTube
The highlight event for the month-long campaign is the setting up of Happiness Walls on the International Day of Happiness (20th March). The idea is to set up a happiness wall in either your school, business or a public place, and ask people to post their happy thoughts, acts or wishes.
There are many ideas to get you started on their website and once you have decided on your location, you can share it on their website and be added to the happiness map. It’s a great way to promote your own event and see where other walls are located in your area.
Taking into account the current research that highlights the many serious health risks that the sustained stress of negative emotions can create, any attempt to habitualize and promote happiness as a daily human right, is a goal worth pursuing.
The Happy Acts campaign is on now and runs every day throughout March.
Everybody likes to feel good. It’s one of the very few opinions that all humans—of every race, color, creed, religion, and political persuasion—have in common.
We like to feel good, and positive emotions just plain feel good. They don’t necessarily need a reason or cause behind them for us to enjoy them; we just do!
Experiencing emotions like happiness, excitement, joy, hope, and inspiration is vital for anyone who wants to lead a happy and healthy life. Luckily, you don’t need to experience them all the time to reap the benefits of positive emotions. These often-fleeting moments can be the ones that make all the hard work and struggling in life worth it, the spice that brings flavor to your life.
The Positive Psychology toolkit is a science-based, online platform containing 170+ exercises, activities, interventions, questionnaires, assessments and scales.
What are Positive Emotions? A Definition
Before diving too deep into positive emotions, we should start by making sure we’re all on the same page about emotions, and positive emotions in particular.
Positive emotions are not simply “happy feelings” that we chase to feel momentary pleasure; like the more negative emotions, they play a significant role in everyday life.
There are many ways to define “emotion,” but they generally fall into one of two camps:
Emotions are a state or feeling that cannot be conjured up at will.
Emotions are attitudes or responses to a situation or an object, like judgments (Zemach, 2001).
Most current scholars fall into the second camp, viewing emotions as the outcome or result of something, provoked by an action or by being on the receiving end of an action. The implications of embracing one view over the other are fascinating, but for the purposes of understanding positive emotions and their role in psychology, it’s not necessary to choose between the two camps; whether we can consciously choose our positive emotions or whether they are a direct result of some action or experience, it is mainly their effects that are of interest to the positive psychologist.
Narrowing down to positive emotions, there are two popular ways of defining them that loosely correspond to the two camps noted above. They have been defined as “multicomponent response tendencies” that last a short period of time (Fredrickson, 2001), aligning roughly with the second view, and as mental experiences that are both intense and pleasurable (Cabanac, 2002), adhering more closely to the first view.
Whichever definition you think fits best, the most important things we need to know about them are (a) which emotions they are, (b) what is their purpose or point, (c) how we can improve our experience of them, either in quantity or quality, and (d) what effects they have on us.
Positive Emotion Words People Use
Let’s dive right into Point A: which emotions are positive.
The list of positive emotions that people experience is nearly endless. Not all of these words refer to emotions as scholars understand them, but they are the words most often used by people in describing their own emotions, which gives us a good foundation for positive emotions as they are commonly experienced.
Joy – a sense of elation, happiness, and perhaps even exhilaration, often experienced as a sudden spike due to something good happening.
Gratitude – a feeling of thankfulness, for something specific or simply all-encompassing, often accompanied by humility and even reverence.
Serenity – calm and peaceful feeling of acceptance of oneself.
Interest – feeling of curiosity or fascination that demands and captures your attention.
Hope – feeling of optimism and anticipation about a positive future.
Pride – a sense of approval of oneself and pleasure in an achievement, skill, or personal attribute.
Amusement – a feeling of lighthearted pleasure and enjoyment, often accompanied by smiles and easy laughter.
Inspiration – feeling engaged, uplifted, and motivated by something you witnessed.
Awe – an emotion that is evoked when you witness something grand, spectacular, or breathtaking, sparking a sense of overwhelming appreciation.
Elevation – the feeling you get when you see someone engaging in an act of kindness, generosity, or inner goodness, spurring you to aspire to similar action.
Altruism – usually referred to as an act of selflessness and generosity towards others, but can also describe the feeling you get from helping others.
Satisfaction – a sense of pleasure and contentment you get from accomplishing something or fulfilling a need.
Relief – the feeling of happiness you experience when an uncertain situation turns out for the best, or a negative outcome is avoided.
Affection – an emotional attachment to someone (or even a pet), accompanied by a liking for them and a sense of pleasure in their company.
Cheerfulness – a feeling of brightness, being upbeat and noticeably happy or chipper; feeling like everything is going your way.
Surprise (the good kind!) – a sense of delight when someone brings you unexpected happiness or a situation goes even better than you had hoped.
Confidence – emotion involving a strong sense of self-esteem and belief in yourself; can be specific to a situation or activity, or more universal.
Admiration – a feeling of warm approval, respect, and appreciation for someone or something.
Enthusiasm – a sense of excitement, accompanied by motivation and engagement.
Eagerness – like a less intense form of enthusiasm; a feeling of readiness and excitement for something.
Euphoria – intense and all-encompassing sense of joy or happiness, often experienced when something extremely positive and exciting happens.
Enjoyment – a feeling of taking pleasure in what is going on around you, especially in situations like a leisure activity or social gathering.
Optimism – positive and hopeful emotion that encourages you to look forward to a bright future, one in which you believe that things will mostly work out.
Happiness – a feeling of pleasure and contentment in the way things are going; a general sense of enjoyment of and enthusiasm for life.
Love – perhaps the strongest of all positive emotions, love is a feeling of deep and enduring affection for someone, along with a willingness to put their needs ahead of your own; it can be directed towards an individual, a group of people, or even all humanity.
This list captures a good deal of the positive emotions we experience, but it’s certainly not an exhaustive list—I’m sure you can think of at least one or two more!
Now that we have an idea of the kinds of emotions we’re talking about, we can move on to another important question: what’s the point?
Why do We Need Positive Emotions? What Good are They?
Aside from simply feeling good, positive emotions are also an important piece of the happiness puzzle. While you will probably not achieve lasting happiness and well-being based on temporary, hedonic pleasure alone, positive emotions often provide the foundation for those fleeting but meaningful moments that make life worth living; for example, the joy of saying “I do” to your significant other, the love that overwhelms you upon holding your newborn for the first time, or the immense satisfaction you get from achieving something great in your career.
Although positive emotions may seem to have little purpose besides making us “feel good,” they actually do a few very important jobs.
The Role of Positive Emotions in Psychology
The “point” of positive emotions depends on who you ask; you will likely get a different answer from experts in different fields.
A philosopher might say “to balance out the negative emotions.”
A poet might say “to inspire authentic works of art.”
A marketing executive might say “to make it easier to sell things.”
A cynic might say “what are those?”
Okay, those examples may be a bit tongue-in-cheek, but clearly there can be a very wide range of ideas on the purpose of positive emotions!
You will even get different answers within the field of psychology itself.
An evolutionary psychologist might respond “to enhance human beings’ chances of survival and reproduction.”
A social psychologist might say “to form the bonds that connect us to others.”
A positive psychologist may say “to make life worth living.”
Or, she might say “to broaden our awareness and build our inner resources.” That is the gist of Barbara Fredrickson’s groundbreaking “Broaden-and-Build Theory” of positive emotions. Read on to learn more about this theory.
A Short Summary of Fredrickson’s Broaden-and-Build Theory
Fredrickson introduced the Broaden-and-Build Theory of positive emotions in 1998. The theory provides a convincing explanation of the “point” of positive emotions: to open our minds, broaden and expand our awareness, and facilitate the building and development of resources, including knowledge, skills, abilities, and relationships.
In the words of Fredrickson herself:
“…these positive emotions broaden an individual’s momentary thought-action repertoire: joy sparks the urge to play, interest sparks the urge to explore, contentment sparks the urge to savour and integrate, and love sparks a recurring cycle of each of these urges within safe, close relationships.” (2004, p. 1367).
The effects of these emotions are in sharp contrast to the effects of negative emotions, or those experienced in a dangerous situation (e.g., fear, terror, anxiety), which usually have the effect of narrowing our focus and limiting our myriad options to the one or two best suited for survival. In such situations, these automatic responses are vital for ensuring that we make it out alive; however, in situations that are not life-threatening, we don’t need such a narrow perspective or limiting of options.
This is where positive emotions are more advantageous—instead of limiting our scope, they expand it to allow for creative thought and action. Instead of narrowing our focus to one or two responses, they expand our awareness to take in the much wider array of responses we can choose from.
This broadening of our horizons allows us to play, to learn, and to acquire lasting knowledge and skills that we can carry with us throughout our lives. These resources are may be physical, emotional, psychological, social, and even mental, but no matter what kind of resources we acquire through this broadening, they are enduring.
These resources acquired and developed through experiencing positive emotions have been shown to result in many benefits throughout the several domains of life.
Among the many health benefits of positive emotions is a reduction in stress and a boost to general well-being. Positive emotions can actually act as a buffer between you and stressful events in your life, allowing you to cope more effectively and preserve your mental health (Tugade, Fredrickson, & Barrett, 2004). In addition, in 2006 researchers confirmed that experiencing positive emotions helps you modulate your reaction to stress and allows you to recover from the negative effects of stress more quickly (Ong, Bergeman, Bisconti, & Wallace).
Positive emotions may also protect you from the sniffles! Students who were randomly assigned to writing about intense, positive experiences for three days, 20 minutes a day, made significantly fewer visits to the student health center for symptoms of illness, compared to students who wrote about a neutral topic (Burton & King, 2004).
Experiencing positive emotions may also encourage individuals to make healthier decisions, indirectly contributing to better health. Herzenstein (2008) found that several positive emotions lead to a variety of health benefits, including:
Happiness resulted in increased risk- and variety-seeking and gain-focused behavior
Contentment resulted in increased risk avoidance and loss-focused behavior.
Positive emotions can also facilitate more effective coping, which boosts health by providing a buffer against symptoms of depression (Dolphin, Steinhardt, & Cance, 2015). In addition, being mindful and taking the time to savor positive emotions can provide an extra buffer against symptoms of depression while boosting psychological well-being and life satisfaction (Kiken, Lundberg, & Fredrickson, 2017).
Another health benefit of positive emotions is that they may result in a stronger heart; Kok and colleagues (2013) found a connection between a healthy heart rate and the experience of positive social emotions. Similarly, a meta-analysis of several studies found that well-being was significantly related to good cardiovascular functioning, general health, and longevity overall (Howell, Kern, & Lyubomirsky, 2007).
How Positive Emotions Foster Resilience and Improve Memory
In addition to promoting good physical and psychological health, positive emotions have been found to relate to both resilience and memory.
A study from Peng and colleagues (2014) found that positive emotions and resilience are positively correlated, indicating that one leads to the other or they share a bi-directional relationship. We also know that resilience is significantly related to emotional regulation, suggesting that the experience of many positive emotions (and the management of negative emotions) allows some individuals to “bounce back” better than others (Tugade & Fredrickson, 2004). Finally, a study by Cohn and colleagues found that positive emotions have a direct effect on resilience, which in turn helps build a strong sense of life satisfaction (2009).
These effects may be due to the “broadening and building” that positive emotions seem to provoke; the more positive emotions a person experiences, the stronger their perception of a positive baseline state to “bounce back” to after failure or tragedy. Additionally, experiencing consistent positive emotions might encourage a person to seek out a wide variety of sources of meaning and fulfillment, sources they can depend on to pull them back up to their feet when they get knocked down.
Overall, there is evidence to suggest that positive emotions can protect against memory impairment (MacKenzie, Powell, & Donaldson, 2015). It is unclear how this protection may work, although it may be explained through the Broaden-and-Build Theory as well. Positive emotions may expand focus and memory capacity and enhance the ability to remember both central and peripheral details (Yegiyan & Yonelinas, 2011).
Both enhanced resilience and better memory can provide benefits in many domains of life, including in the workplace. In fact, there are several ways that positive emotions can lead to better productivity and more effective work.
How Positive Emotions Can Improve the Workplace
Positive emotions have been shown to have a positive impact on relationships (romantic, friends, and family), therapy and counseling outcomes, grades and academic achievements, and personal development (Linley, Joseph, Maltby, Harrington, & Wood, 2009); now we can add one more domain to this list: the workplace.
As much as we may try to separate them, our emotions and personal life do have an impact on our work. Luckily, this can work in positive as well as negative ways. Positive emotions have led to enhancements and improvements in work life, physical and mental health, social relationships, community involvement, and income (Danner, Snowdon, & Friesen, 2001; Lyubomirsky, King, & Diener, 2005), all of which are either directly or indirectly related to work.
Enhancing Employee Engagement
A recent study by Goswami, Nair, Beehr, and Grossenbacher (2016) cemented the relationship between positive emotions and employee engagement—as well as showing a link between leaders’..
Albert Ellis’s ABC Model is a major part of his rational-emotive behavior therapy (REBT). REBT served as a sort of precursor to cognitive-behavioral therapy (CBT), and the ABC Model is now a treatment commonly used in CBT interventions.
This article will cover what the ABC Model is, how it and REBT relate to CBT, and finally the ways in which the ABC Model works to target dysfunctional thoughts and beliefs.
The Positive Psychology toolkit is a science-based, online platform containing 190+ exercises, activities, interventions, questionnaires, assessments and scales.
A Brief History on CBT & REBT
CBT has its direct roots in Aaron Beck’s cognitive therapy (CT), which he developed when he decided that contemporary treatments for depression focused too much on past events rather than current beliefs (such as the belief that one is not good enough for their job or partner) (Beck, 2011).
Beck’s CT has its own roots, though, and Albert Ellis’s REBT is one of those roots. Specifically, REBT is “the original form and one of the main pillars of cognitive-behavioral therapies (CBT). Alongside with the cognitive therapy (CT) created by Aaron Beck (1976), it served as the basis for the development of CBT” (David et al., 2018).
In other words, REBT is both a precursor to and a form of CBT. The main things that set REBT and CBT apart from preceding cognitive therapies is that REBT and CBT both target beliefs as a fundamental course of treatment.
For the purposes of this article, we can consider REBT to be a subset of CBT, and we can consider the ABC Model to be an REBT treatment plan as well as a CBT treatment plan.
More Theory By Albert Ellis: What Is The ABC Model?
The basic idea behind the ABC model is that “external events (A) do not cause emotions (C), but beliefs (B) and, in particular, irrational beliefs (IB) do” (Sarracino et al., 2017). Another way to think about it is that “our emotions and behaviours (C: Consequences) are not directly determined by life events (A: Activating Events), but rather by the way these events are cognitively processed and evaluated (B: Beliefs)” (Oltean et al., 2017). Furthermore, as evidenced by the first quote, REBT divides beliefs into “rational” and “irrational” beliefs.
Ellis initially believed that REBT was incompatible with religiosity, or at least with “absolute” religiosity, though he has come to accept that certain types of religiosity are compatible with REBT (Ellis, 2000). Specifically, according to Ellis, belief in a “loving God” can lead to positive mental health outcomes, while belief in an “angry” God can lead to negative mental health outcomes. This is surely a bold claim but shows the evolution of Ellis’s thoughts on REBT and the ABC Model, particularly how they relate to religion.
The ABC Model can also be referred to as the “ABCDE” Model, where D stands for the Disputation of Beliefs and E stands for New Effect, the result of holding healthier beliefs (Jorn, 2016).
This is no different than the ABC Model in practice, because Disputation is a key part of the ABC Model (such as in the case of disputing an irrational belief to turn it into a rational belief), and New Effect is simply the result of that disputation. Calling it the “ABCDE” Model instead of the “ABC” Model simply makes these two steps more explicit, but they are present regardless of what one calls it.
In both the ABC Model and the ABCDE Model, this is what a typical series of thoughts might look like (with the only difference being that the ABCDE Model is explicit about “D” and “E”:
A: Activating Event (something happens to or around someone)
B: Belief (the event causes someone to have a belief, either rational or irrational)
C: Consequence (the belief has led to a consequence, with rational beliefs leading to healthy consequences and irrational beliefs leading to unhealthy consequences)
D: Disputation (if one has held an irrational belief which has caused unhealthy consequences, they must dispute that belief and turn it into a rational belief)
E: New Effect (the disputation has turned the irrational belief into a rational belief, and the person now has healthier consequences of their belief as a result)
How To Treat Cognitive Distortions & Irrational Beliefs With The ABC Model
When it comes to CBT, REBT, and the ABC Model:
“a key element is helping clients see the connection between an event that may serve as a trigger, and how irrational evaluations may cause emotional and/or behavioral consequences that often in turn lead to increased distress or conflict” (Malkinson & Brask—Rustad, 2013).
This is the main idea behind the ABC Model, as one does not necessarily have to change their environment, they simply have to recognize and change their reactions to their environment.
This is indicated by the fact that three 45-minute learning sessions about the ABC Model have been shown to be effective in reducing symptoms ofdepression and anxiety as well as reducing dysfunctional thinking, while increasing self-esteem and feelings of hope (Saelid & Nordahl, 2017). It is important to note that this was achieved in an experimental group where 18 of the 20 participants “reported not having had any previous knowledge of the links between thoughts, feelings and behaviour”.
Regardless, this indicates that the ABC Model partially works by showing people the connection between their beliefs and their emotions, and by showing people that the events around them do not necessarily dictate their emotions.
The ABC Model has been successful in treating anger issues as well (Fuller et al., 2010). This treatment was especially promising, because participants were able to deal with their anger while confronting potential anger triggers, rather than simply avoiding anger triggers. This underscores the idea that the ABC Model works by changing one’s beliefs in response to the environment around them, rather than changing the environment around them.
In cases of unhealthy anger, and other instances of unhealthy negative emotions, the key difference is between rational and irrational beliefs (Ziegler & Smith, 2004). In certain situations, however, the ABC Model cannot be deployed as is. For example, treating someone who is grieving, such as someone in bereavement from losing a child, requires a modification. This is because in the case of grief, “‘logical’ disputation is not useful, but instead, legitimizing and normalizing is used: losing a child is in and by itself not logical” (Malkinson & Brask-Rustad, 2013).
In general, the ABC Model works by turning irrational beliefs about activating events into rational beliefs, which in turn leads to better consequences and emotions. In some cases, however, such as grief, it is not about turning irrational beliefs into rational beliefs, but it is instead about “legitimizing and normalizing” the beliefs that are present. In most cases, though, the ABC Model targets irrational beliefs.
5 ABC Model Worksheets (PDF)
This extremely short worksheet simply lists the five steps of the ABC model in descending order. It goes from Activating Event to Beliefs to Consequences to Disputations of beliefs to Effective new beliefs. This worksheet does not offer too much explanation but could be a good resource to hang in an office or classroom as a reminder to practice the ABC Model.
Understanding our response to stress and adversity
This three-page worksheet, which appears to be part of a longer packet from a Dartmouth College, is a great stand-alone way to learn about the ABC Model. The worksheet clearly and briefly explains what the ABC Model is and how to use it effectively. This is a good option for someone looking to quickly learn about the ABC Model and how to use it in themselves.
ABC Problem Solving Worksheet
This worksheet serves as a prompt to help someone work through the ABC Model whenever they may need to. This would be another great resource to hang in a classroom or office as a reminder of the connection between beliefs and emotions. This worksheet is also useful because it does not require any prior knowledge about the ABC Model to use it successfully.
CBT Exercise – The ABCD Method
This is similar to the above worksheet, as it also walks one through the ABC Model whenever one may need it. It may be more appropriate for adults, however, while the preceding worksheet may be more appropriate for younger people (simply because it is more colorful and prompts for fewer responses). This worksheet also works regardless of one’s prior knowledge of the ABC Model.
This worksheet also walks one through the ABC Model but is targeted towards therapists to give to their clients. It is also slightly more visual than the other worksheets which walk one through the ABC Model, so it may be helpful for anyone who prefers visual methods, not just clients of therapists. By providing boxes instead of lines, this worksheet also allows one to draw rather than write, which may also be helpful for younger clients.
A Take Home Message
The main takeaway from the ABC Model is that while environmental factors can certainly negatively affect our lives, we do have some control over how we react and respond to those factors. This does not mean that no harm can come to someone with a positive attitude, but it does indicate that a positive attitude can get someone through rough times, or help them better enjoy the good times. Having a positive attitude also does not cost anything, so it cannot hurt to try to keep a positive outlook.
In the true spirit of positive psychology, we would all be better off if we remembered the principles of the ABC Model. In many situations, we may not be able to change the environmental factors (or Activating Events) that surround our daily lives. What we can do, though, is keep in mind the power of our own beliefs.
Beck, J.S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.), New York, NY: The Guilford Press.
David, D., Cotet, C., Matu, S., Mogoase, C., Stefan, S. (2018). 50 years of rational-emotive and cognitive-behavioral therapy: A systematic review and meta-analysis. Journal of Clinical Psychology, 74(3), 304-318. doi:10.1002/jclp.22514
Ellis, A. (2000). Can rational emotive behavior therapy (REBT) be effectively used with people who have devout beliefs in god and religion? Professional Psychology-Research and Practice, 31(1), 29-33. doi:10.1037/0735-7028.31.1.29
Fuller, J.R., DiGiuseppe, R., O'Leary, S., Fountain, T., Lang, C. (2010). An Open Trial of a Comprehensive Anger Treatment Program on an Outpatient Sample. Behavioural and Cognitive Psychotherapy, 38(4), 485-490. doi:10.1017/S1352465810000019
Jorn, A. (2016). Rational Emotive Behavior Therapy. Psych Central. Retrieved from https://psychcentral.com/lib/rational-emotive-behavior-therapy/
Malkinson, R., Brask-Rustad, T. (2013). Cognitive Behavior Couple Therapy-REBT Model for Traumatic Bereavement. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 31(2), 114-125. doi:10.1007/s10942-013-0164-1
Oltean, H.R., Hyland, P., Vallieres, F., David, D.O. (2017). An Empirical Assessment of REBT Models of Psychopathology and Psychological Health in the Prediction of Anxiety and Depression Symptoms. Behavioural and Cognitive Psychotherapy, 45(6), 600-615. doi:10.1017/S1352465817000133
Saelid, G.A., Nordahl, H.M. (2017). Rational emotive behaviour therapy in high schools to educate in mental health and empower youth health. A randomized controlled study of a brief intervention. Cognitive Behaviour Therapy, 46(3), 196-210. doi:10.1080/16506073.2016.1233453
Sarracino, D., Dimaggio, G., Ibrahim, R., Popolo, R., Sassaroli, S., Ruggiero, G.M. (2017). When REBT Goes Difficult: Applying ABC-DEF to Personality Disorders. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 35(3), 278-295. doi:10.1007/s10942-016-0258-7
Ziegler, D.J., Smith, P.N. (2004). Anger and the ABC model underlying Rational-Emotive Behavior Therapy. Psychological Reports, 94(3), 1009-1014.
It will enable you to make a lasting impact on the lives of your clients, students or team-members and receive well-earned, warm recommendations that result in new growth opportunities for your practice or business.
What if you lack experience?
An addition to Mindfulness X is the Train-the-Trainer course. This part of the program teaches you what is needed to effectively deliver the training and – since its introduction – has helped guide our members to address many of the essential questions raised during their practice.
Combined with the instruction manual and lectures for practitioners (available in both video and audio), you’ll gain the confidence needed to deliver your own mindfulness-based workshops, 1-on-1 coaching, teaching and/or corporate programs. As always, you are advised to use this training package within the boundaries of your professional expertise.
What will you get?
Besides all of the materials aimed at you, the practitioner, Mindfulness X contains PowerPoint slides, a printable workbook for participants, guided meditations and even a certificate that you can reward clients with upon successfully completing your training.
All the included materials have been carefully formatted and designed to save you a tremendous amount of time. Simply send them to your printer and get started with the training right away.
We are introducing the new and upgraded Mindfulness X package at a discounted relaunch rate of 35% off for one week only.
This means you can purchase and download Mindfulness X right now for $750 instead of its regular price of $1,150.
Bonus 1 – Full White Label Rights. Included in this relaunch package, we are giving away the full white label rights to Mindfulness X. This means you can use all of the materials in your practice, under your own name, brand, and logo.
Bonus 2 – Intake Assessment Form. A structured intake assessment form to effectively screen your participants before the start of the training.
Bonus 3 – Mindfulness Quotes. List of mindfulness quotes you can send to your participants as a daily dose of inspiration.
Bonus 4 – Certificate Template. A certificate template that you can reward your participants with upon completing your training (customizable Word-format).
You can download all of these bonuses in the online Mindfulness X learning environment.
Should you have any questions, please don’t hesitate to leave a comment!
We’re always here and happy to help.
See you inside the program soon,
Seph Fontane Pennock
Positive Psychology Program
P.S. There are only 200 packages available at this discounted rate and as our loyal email subscriber you are literally the first person to hear about this.
Claim your package on this page right now before the 200 relaunch packages run out.
This is true in business, health, and can even be applied to personal life.
The fact is unless an individual is able to organize, analyze and process the data they’re working with, reaching an accurate conclusion can be difficult.
Firstly, because one needs to know exactly what they’re working with. And secondly, because organizing the information in an orderly fashion provides a more clear picture, which makes the decision-making process much easier.
When it comes to personal well-being, one’s mood plays an important role in determining energy levels, where the attention is focused, and the actions taken. One study suggested that:
“when participants were in a happy mood, they processed information more globally compared to when they were in a sad mood.” (Schmid, Mast, Bombari, Mast and Lobmaier, 2011) “
It shows that, when individuals are more positive, they gather more information from the outside world. With more information, people can make better and more clear choices, which is always a good thing.
The Positive Psychology toolkit is a science-based, online platform containing 190+ exercises, activities, interventions, questionnaires, assessments and scales.
What Is A Mood Chart? And For Who Is It?
To have a better understanding of what we’re measuring when looking at moods, we can start by agreeing on a few definitions on which to build our conclusions.
There are three key terms that will assist us in the process: affect, emotions, and mood.
Affect refers to our overall feelings, which we experience throughout our days, weeks and months. Emotions arise as a result of specific events or situations. Moods, on the other hand, are the background feelings that accompany us without any particular reason or cause. (Emotions and Mood, 2005)
Psychologists define mood as a number of persistent feelings that accompany our perception and evaluation of incoming stimuli. Mood has a huge influence on the way we react, specifically in the actions we take and the feelings that get created throughout that process. (Amado-Boccara, Donnet and Olie, 1993)
The tricky thing about moods is that they are transitory, and can come and go without warning, cause, or reason. This is why, unlike emotions, which arise due to, or as a result of, specific events, moods represent our overall state, and determine how we interpret or approach external stimuli. Also, they can last much longer than emotions. (Mood, 2015)
One’s personality can influence the way a mood is displayed, and the actions that one takes during such phases. People who are more optimistic and positive, who gather more information from the surrounding stimuli, are able to have a better view of reality, and adjust their actions according to what’s going on at that moment.
That’s why, the purposeful act of widening our attention to spot positive stimuli not only helps us maintain our positive affect, but provides us with more resources by which to refer back to it. (Wadlinger and Isaacowitz, 2006)
Those who are pessimistic or insecure, look for evidence to support their downcast state, and search for ways to reason or explain their negative affect. (Norbert and Gerald, 1983)
This feedback loop might strengthen the negative thoughts, and prolong the experience of such negative feelings. As the incoming information from the outside world is limited to only that which agrees or supports the dominant thoughts in the mind.
Without an ability to have a more accurate view of the environment, a biased and a more subjective mental state is created and maintained. This is where the tracking benefits of a Mood Chart can provide crucial information about when, where, and how often such moods are experienced and expressed.
With enough data and information, a pattern of the highs and lows can be identified, as well as the factors that may have caused them. This tool is handy for those experiencing depression, bipolar disorder, anxiety, but also those wishing to know more about themselves.
Why It’s Good For Your Mental Health
Why should we care about tracking and noticing our mood patterns? Well, because the way we feel impacts the way we think. And the way we think determines the actions we take, which in turn influences our experiences and ultimately, our feelings. This is a good example of how connected and cyclical our systems are.
The below quote by Darwin emphasizes the connected nature of our body organs and adds some explanation to this phenomenon.
“When the mind is strongly excited, we might expect that it would instantly affect in a direct manner the heart; and this is universally acknowledged and felt to be the case. Claude Bernard also repeatedly insists, and this deserves especial notice, that when the heart is affected it reacts on the brain; and the state of the brain again reacts through the pneumo-gastric nerve on the heart; so that under any excitement there will be much mutual action and reaction between these, the two most important organs of the body.” Darwin, 1872, p.69.
From this, we can deduce that maintaining a positive mood ensures a balanced outlook and notably influences our well-being. On the other hand, being in a constant state of nervousness, where our feelings go up and down as a result of external stimuli, creates an imbalance that leads to ill-being. (Desmet, Vastenburg, and Romero, 2016)
A continued mood imbalance, in either the positive or negative outlook, leads to a lopsided view of the world. Rather than seeing reality as is, and making objective decisions based on available information, individuals focus on and pick up stimuli that support their dominant thoughts and emotions.
An inability to understand and express these strong feelings can cause long-term problems. One study showed that in the wake of trauma, the habit of ruminating on the negative event, a wish to suppress its undesirable thoughts, as well as the inability to associate with that past event, so as to fully process and move beyond it, is correlated with more symptoms of traumatic behavior and their severity. (Desmet, Vastenburg, and Romero b, 2016)
Individuals with such poor “cognitive and emotional adaptation strategies, are involved in the development of PTSD (post-traumatic stress disorder)”, as they are unable to accept the emotionally charged event, keeping it in the mind and creating discomfort. In turn, this negatively influences new experiences. (Desmet, Vastenburg, and Romero c, 2016)
While these avoidance strategies might be efficient in the short-term, in the long-term they prove to be quite damaging. One study showed that, a continued disassociation to the traumatic event leads to emotional numbing, which manifests into a feeling of detachment to people and events that once were a source of pleasure. This greatly lowers the person’s capacity to experience their full range of emotions. (Berna, Vaiva, Ducrocq, Duhem and Nandrino, 2014)
The bottom line is captured by one study which showed that there is a strong correlation between the repetition of abstract thoughts and depressive moods. On the other hand, the reiteration of concrete thoughts complemented executive functions. This means that individuals with ruminating thoughts, based on skewed interpretation of negative events (influenced heavily by downcast emotions), lead to depression and an inability to reason clearly, causing a decline in executive operation. (Philippot and Agrigoroaei, 2016)
Having a mind that’s filled and occupied with ruminating negative thoughts and self-talk leads to aggression, hopelessness, and can cause depression, suicidal thoughts, anxiety, as well as a slew of other mental illnesses.
This is why tracking one’s mood can be useful not only for individuals currently suffering from mental illnesses, but also those wishing to add more balance and objectivity to their lives.
As one begins to plot and track mood patterns, the overall frequency of such moods emerges. The ability to see the number and the intensity of such dysfunctional thoughts enables the person to better understand whether their “sad mood will be a transient state or will become protracted, increasing the risk of developing clinical depression”. (Steenbergen, Sellaro, van Hemert, Bosch and Colzato, 2015)
There are several tools available that organize and track moods, and other factors that influence the way we feel and think.
The Bullet Journal Mood Tracker
One such easy and simple tool is known as the Bullet Journal Mood Tracker.
The name itself ‘bullet’ readily suggests what to expect from this process: clarity, organization, and effectiveness. And the fact that creating such a tracker can be done by the individual suggests there is a lot of autonomy for the person, as they can monitor exclusively the items most applicable to them.
In many ways, it’s a part planner, as the person lists the activities they want or need to accomplish, but also part journal, as the emotions and feelings for that day can be identified. The relationship between the activities and the emotions felt at the end of the day is what provides the data for pattern observations.
This bullet journal system was developed by Ryder Carroll, a Brooklyn-based designer. The inspiration was to provide a rapid logging process, which takes less time and effort than traditional long handwritten entries.
Carroll identifies the following building blocks of the process:
Topics and Pages – help to easily identify the material that will be covered, with a
short and simple title, as well as page numbers.
Bullets – organize the actions and entries into: tasks, events, and notes.
Tasks – marked by a dot, describe the work to be done. Using symbols identify
the status of that task, for example: X – task completed; > – task migrated;< – task scheduled.
Events – identified by an O, show date-related occurrences, which can range
from a positive social event, to a negative personal encounter. The key is to
keep the description as objective as possible (at least at this step of the
Notes – represented by a dash “-“. Here more details can be provided about the
above topics. These can include facts, thoughts, ideas, and observations.
Signifiers – any additional symbols that can provide more emotions, and
thoughts regarding the entries. For example, * – can represent urgent tasks; ! – can
provide inspirational or important information; an eye – can show things that require
further research, or discovery.
Once the organizational components have been crafted, individuals can move towards the Modules, which consist of:
Index – a repository of topics featured in the journal, with their relevant pages.
Future Log – items to be done or completed in the coming months.
Monthly Log – a bird’s-eye view of actions/events coming up that month.
Daily Log – things to do for that day. Can be done the day of, or the night before. (Carroll, 2018)
Due to the flexible nature of such journals, the focus areas can differ from person to person, based on immediate needs, long-term goals, and other interests. Some common themes include: a daily log; a habit tracker (diet, sleep, physical activity, social life, and even stress levels); a mood tracker to identify the emotions and things that triggered it (ex: sadness, triggered by upsetting news, or personal events); and thoughts (ex: mantras; advise; interesting facts).
The information collected in the journal can remain private for personal use and analysis, or it can be shared with a mental health care provider (when appropriate and comfortable for the client). (Wong, 2017)
For more inspiration and ideas on how to build and utilize the bullet mood journal, click to visit this website.
The Mood Ring Color Chart (PDF)
Another way to identify moods and emotions is with mood rings.
This accessory was introduced in the 1970s, and operates with a liquid crystal that changes color with differing temperature. The idea behind the design was that blood flow relies on temperature and mood (ex: under stress, blood is directed toward internal organs, decreasing flow to the extremities). (Helmenstine, 2011)
The different colors represent varying states of emotion. Below are some of the colors and what they tend to represent:
Dark brown: On Edge/Restless
Dark yellow: Unsettled/Surprised
Red: High Energy/Angry
Purple: Romantic/Sensual (Mood Ring Color Chart, 2018)
For more color combinations and what they represent, check out the following sources:
There are also several ready-made Mood Charts available online. All you have to do is print them and start utilizing the tools. Here is a list of a few you can work with today:
1. Daily Mood Chart
A simple chart that tracks your mood scale between 1-10 (10 being best, 1 being worst). Asks for your hours of sleep, and provides a space for comments.
2. Mood Chart
A chart built by Harvard’s Dr. Peter Brigham. The categories on this chart and more in-depth and include categories such as: Exercise/Medication; Energy/Mood; Sleep; Irritability (on a scale from 0-3); as well as an area for Events/Notes/Observations (to track triggers of the mood).
3. Daily Chart
This chart, offered by the Gateway Psychiatric Services provides a space to review Actions; Sleep (by looking at the time went to bed and time got out of bed, and total hours of sleep); Energy levels, that cause intensity or impulsivity, as well as, Slow moments of Dullness/Obsessing. As always there is a room for Events, or memory cues, for that day.
4. Mood/Sleep Chart
The saying goes – keep it simple, stupid, and that’s exactly what this chart provides. It strips down the tracking to the bare minimum of: mood level, sleep, energy level and a space for notes.
5. Do It Yourself Chart
Those wishing to use their creativity and create a personalized mood chart can use this step by step process provided by WikiHow. The steps are simple and straightforward. Decide the format, what you’ll be tracking, create a rating scale, determine how often you will be charting and tracking, and then start using.
6. Electronic Mood Charts
Living in this technological age has its advantages. There are many apps available to help you track your mood without the need of a pen, paper, or journal. Your dedicated smartphone could be your closest companion.
A) Mobile Apps
Here is a list of various mood apps and a comparison between what they provide based on: price; happiness level; different emotions; correlation located to your mood; correlation to the treatments of your mood; correlation of people to your mood; correlation of activities to your mood; and creating your own items to correlate.
B) Programs and More Apps
PsychEducation lists their top 4 programs and apps that can assist you in tracking your moods and emotions. These include: MoodPanda; BeatingBipolar; Optimism program; and Emotion Sense.
Mood Journals & Mood Logs
Managing emotions is a challenge every individual faces. For some, recognizing and managing emotions can come easy, for others, not so much. Especially for individuals suffering from a mental illness, such as depression, anxiety, bipolar disorder, and others. As the mind becomes subjective, and sensitive to only a particular type of stimuli, it takes away one’s ability to objectively view and review the changing patterns of mood.
When it comes to individuals experiencing depression, the problem can be that they completely detach from their emotions. As Dr. O’Connor said:
“The emotional self has largely been lost to the depressive.” (Stein, 2018)
The important thing to note, however, is that it is not the feelings and emotions themselves that are the issue, rather, it is the coping mechanisms that the individual created that are building barriers and obstacles to leading a more balanced life. In fact:
“the danger of tuning out your feelings, therapists say, is that if you lose your ability to feel painful feelings, you can also lose..
When was the last time you felt fully recovered from your stressful work environment? Job demands are higher than ever and with increased work speed, job insecurity and complex work environments the pressure is on for employees.
Organizations are aiming to support their staff’s work recovery by providing free gym memberships and massages – economist Milton Friedman’s phrase “There is no such thing as a free lunch” comes to mind.
But there is more to work recovery than hitting the gym for an hour. The latest scientific findings in the field of Positive Psychology indicate that there are five fundamental elements which (ideally in combination) promote completely winding down from stressful work.
The Positive Psychology toolkit is a science-based, online platform containing 190+ exercises, activities, interventions, questionnaires, assessments and scales.
Stress and Lack of Recovery
We feel stressed when we feel unable to cope with the demand being placed on us. However, stress is not necessarily bad for us. As long as we manage to recover after a stressful period, there is little harm in feeling stressed. Persistent coping with acute and chronic stressors, however, leads to wear and tear on the body (the so-called allostatic load) and can have a profound impact on health.
Chronic stress (and in particular lack of recovery from it) can accelerate disease processes and lead to chronic illnesses. It is a paradoxical fact that the physical reaction to stress is supposed to protect our health, yet these reactions themselves can be harmful (McEwen & Lasley, 2002). So, stress is not harmful per se, but failure to recover properly is.
A Model for Work Recovery
What do you do to recover from a stressful work day? Recovery strategies vary, some of them are more active, such as playing sports, while others are rather passive, like watching television. According to the DRAMMA Model proposed by Newman, Tay & Diener (2014), there are two basic areas of recovery:
Here is how you make the most of each of the five elements.
Time away from work is essential for recovery, especially when we manage to cognitively switch off. Ideally, leisure activities should not draw on the same resources used during work in order to maximize recovery. Therefore, hairdressers cutting their friend’s hair in the evenings or tax agents spending weekends filing their friend’s tax reports will not reach the same level of recovery during their work break despite the fact that they may voluntarily engage in these activities (especially if they do not enjoy doing them).
The same is the case if you find yourself ruminating about work during your time off. In order to maximize recovery, you need to be able to psychologically detach from work and concentrate on something different.
So, make sure your leisure activities help you to disengage from work-related matters. Activities can take the shape of sleeping, watching TV or lying on the beach. But you may find it easier to detach after a busy work day by engaging in arousal seeking behavior or a hobby which demands your full attention such as playing soccer, painting or salsa dancing.
Whether you recover well during leisure time has a lot to do with whether you feel you get to do your own thing. Research shows that independence and self-direction are important factors when it comes to well-being. Say you find yourself running from soccer practice at the local club (of which you are a loyal member) to meeting a friend (who has just lost his job) and then rush home to babysit your children (while your wife takes evening classes at university).
While all these activities may be voluntary engagements, chances are you will not feel particularly recharged at the end of the evening. What counts is how you feel about the activities you engage in. If they feel like an obligation you miss out on an important element for well-being: the sense of designing your time autonomously.
The freedom of autonomous leisure decisions is beneficial because it is based on intrinsic motivation which is a key ingredient for well-being. Only if you feel in charge of designing at least part of your leisure time autonomously, will you get the maximum recovery from the activities you perform.
If this speaks to you, try these two autonomy hacks:
Think of reasons why you are grateful for the activities you engage in. For instance, if you have to walk your dog (and you would much rather watch something on TV), think of the good memories you have with your dog. Remember how much fun this little creature brings to your life and how fortunate you are to be able to have a dog. Be grateful for your buddy. Gratitude leads to positive emotions and increases well-being (B. Fredrickson, 2003). While you will have to leave the house rather than sit on the couch, you will be more intrinsically motivated to do so and feel more autonomy.
One of today’s phenomena is that our leisure time is jam-packed with activities. Despite the fact that we have chosen to do these activities, the sheer number of events and the lack of free time may leave us feeling imprisoned by our calendar. To free up time, you should book “Me Time” in your calendar. This will make it easier to refuse invitations and allows you to choose how you would like to spend the time when it arrives. You may still end up doing something you would normally do, but you will feel more in charge of having made that decision autonomously.
Mastery occurs when you use your skills to overcome a challenge and as a result experience development and growth. One of the most important concepts in Positive Psychology related to mastery is the concept of Flow (Csikszentmihalyi, 2003). Flow is what you experience as a result of an appropriate balance of challenge and skill.
Too much challenge results in stress, too little in boredom. But the right balance provides a flow state which is characterized by a feeling of being completely absorbed in the activity and forgetting about time. Mastery is an important component of work recovery. Serious involvement of effort, skill and commitment provides greater well-being and life satisfaction.
When do you experience flow in your life? Why not try something new such as learning a new language or taking a class in your favorite subject?
Positive Psychology enthusiasts know that meaning is an important element for successful work recovery since it is also an important component of well-being. Engaging in activities which provide a purpose in life has been found to reduce negative emotions, provide a sense of tranquility and peace of mind, affirm self-worth and facilitate growth and development.
Hence, finding purpose in the way we spend our leisure time encourages relaxation. Are you yet to find hobbies which provide you with a sense of purpose? Or is it a matter of looking at the activities you engage in and realizing the purpose they provide?
Connecting with others is one of the most important aspects of life and is linked with higher subjective well-being as it is one of our basic human needs (B. L. Fredrickson & Losada, 2005). Spending your leisure time with friends encourages positive emotions and ultimately improves well-being. This is especially true during times when you feel so stressed that you do not have the energy to catch up with friends. According to Freudenberger and North’s 12 phase Burnout Model withdrawing from social connections is a typical sign of stress-induced depression and actually aggravates it (Freudenberger & North, 1992).
On the other hand, friends can be a great source for some lighthearted fun. When was the last time you engaged in an activity involving play? Sliding down a snowy hill in a toboggan or dressing up for a themed party brings out the child in us. According to Transactional Analysis, it is through the inner child that we bond best with others. Research has found that play raises self-esteem, boosts confidence in decision-making and increases openness to new experiences (Newman, et al., 2014).
A Take Home Message
Clearly, there is more to work recovery than putting your feet outside the office. If you find yourself ruminating about work during your leisure time, you may want to engage in activities which demand full involvement and require skill, effort and commitment as they change your focus and will help you to take your mind off work.
If you feel that you lack the energy to go out and meet friends or go jogging after a long day of work, think again. While it does take an effort to leave the house again (and relaxing on the couch can be a very effective recovery tool), remember that being active and connecting with others are great sources of energy and will leave you feeling better afterwards.
However, if you are feeling like a puppet on a string long after you’ve left the office, you will need to find the time to do your own thing. You can raise this topic with your loved ones and discuss the options. Good communication is key.
Only if you take good care of yourself and switch off properly from work, can you continue to perform at your best and look after others as well.
Csikszentmihalyi, M. (2003). Good Business: Leadership, Flow, and the Making of Meaning. New York: Penguin Books.
Fredrickson, B. (2003). The value of positive emotions: The emerging science of positive psychology is comming to understand why it's good to feel good. American Scientist, 91(July-August), 330-335.
Fredrickson, B. L., & Losada, M. F. (2005). Positive Affect and the Complex Dynamics of Human Flourishing. [Article]. American Psychologist, 60(7), 678-686. doi: 10.1037/0003-066X.60.7.678
Freudenberger, H., & North, G. (1992). Burnout bei Frauen. Über das Gefühl des Ausgebranntseins. Frankfurt: Fischer Verlag.
McEwen, B. S., & Lasley, E. (2002). The End of Stress As We Know It. New York: Dana Press.
Newman, D. B., Tay, L., & Diener, E. (2014). Leisure and subjective well-being: A model of psychological mechanisms as mediating factors. Journal of Happiness Studies, 15(3), 555-578.
Obsessive-compulsive disorder (OCD) is a common psychological disorder that, as the name suggests, is characterized by obsessions and compulsions. These obsessions and compulsions are much more prevalent and debilitating than they are in the general population.
This article will cover the ways that OCD symptoms present themselves, as well as the different ways that OCD can be treated (including ways that OCD can potentially be self-treated). Finally, this article will cover some overlooked aspects of OCD that may be considered positive.
The Positive Psychology toolkit is a science-based, online platform containing 190+ exercises, activities, interventions, questionnaires, assessments and scales.
What Is An Obsessive Compulsive Disorder (OCD)?
Obsessive-compulsive disorder (OCD) is a:
“relatively common, frequently debilitating neuropsychiatric disorder” that is “characterized by repetitive thoughts (obsessions) and repetitive behaviours (compulsions) that are experienced as unwanted” (Pauls et al., 2014).
In the context of OCD, obsessions can be further defined as: “intrusive, repetitive thoughts, images, or impulses”, and compulsions can be further defined as “purposeful, repetitive overt and covert behaviors or rituals performed in an effort to relieve obsessional distress” (Olatunji et al., 2013).
As the definitions above and symptoms below indicate, OCD is not defined by the simple presence of obsessions or compulsions, but by the pervasiveness of these obsessions and compulsions, as well as their unwanted nature.
We can define someone with OCD as someone who experiences pervasive and unwanted obsessions and compulsions, with these obsessions and compulsions negatively affecting their lives.
A good way to further explore what OCD is and what it looks like is to examine some of the symptoms that accompany OCD.
OCD Diagnosis: 20+ Symptoms
While people with OCD may experience different symptoms and different severities of those symptoms, here is a list of over 20 symptoms that people with OCD experience (Abramowitz et al., 2010; Goodman et al., 1989):
Obsessions about causing harm by various means
Checking, reassurance seeking, and related compulsions
Unacceptable (violent, sexual, religious) obsessional thoughts about mental rituals
Obsessions about symmetry
Compulsions involving ordering and repeating
Spending too much time on obsessions
Experiencing interference from obsessions
Experiencing distress from obsessions
Yielding to obsessions
Lacking control over obsessions
Spending too much time on compulsions
Experiencing interference from compulsions
Experiencing distress from compulsions
Yielding to compulsions
Lacking control over compulsions
Inflated sense of responsibility
Ascribing too much importance to thoughts
Feeling the need to control thoughts
Overestimating the possibility of bad things happening
Disliking uncertainty and ambiguity
Now that the symptoms of OCD have been established, the next thing to look at is OCD treatments, starting with exposure and response prevention (ERP).
OCD Treatment: Exposure and Response Prevention (ERP)
Exposure and response prevention (ERP) is a behavioral treatment for OCD that is a form of cognitive behavioral therapy (CBT). ERP comes from a study by Meyer (1966), where the author “exposed patients directly to anxiety-evoking stimuli and then prevented them from carrying out their compulsive rituals” (Abramowitz, 1996). This was the first effective behavioral treatment for OCD to be reported.
ERP is still used today as a treatment for OCD and has recently been shown to be effective for reducing OCD symptoms, as well as for reducing depression symptoms and improving quality of life(Shinmei et al., 2017). ERP can also be successfully used to treat young children with OCD, as long as a few treatment modifications are made, including the involvement of family members in the treatment plan (Herren et al., 2016).
Certain commentators have suggested that ERP leads to higher dropout rates than other types of therapy, but a meta-analysis has found ERP dropout rates to be no higher than other therapies (Ong et al., 2016). This indicates that ERP should be one of the first-line treatments for OCD.
Cognitive Behavioral Therapy (CBT) For OCD
While ERP is a form of CBT, there are other forms of CBT used to treat OCD. An extensive meta-analysis has found CBT to be an effective treatment for reducing OCD symptoms, and that these symptom reductions generally persist after treatment (Olatunji et al., 2013). Another meta-analysis of CBT also found it to be more effective for reducing obsessive-compulsive symptoms than pharmacological intervention alone (Sánchez-Meca et al., 2014).
These findings are especially promising, since there are many ways for people to receive CBT treatment aside from the traditional, in-person therapy route. For example, people can complete self-directed CBT programs online, or people can videoconference with a therapist rather than having to visit in person (Wolters et al., 2017).
Even for people who can visit a therapist in person, online CBT can supplement a treatment plan, or online CBT can be the main treatment plan with in-person therapy serving as the supplement. CBT is also a good option for specific types of OCD, such as OCD with comorbid autism spectrum disorder (ASD) (Kose et al., 2018), postpartum OCD (Challacombe et al., 2017), pediatric OCD (Wu et al., 2016), and pharmacoresistant OCD (Vyskocilova et al., 2016).
As is the case with other disorders, CBT is an appealing treatment plan for its adaptability to both the patient and the specific expression of the patient’s disorder.
10+ Other OCD Therapy Techniques
While CBT is an effective treatment for OCD on its own, some people may still experience OCD symptoms after completing CBT, necessitating adjunct therapies. One of these, music therapy, has been shown to reduce obsessions as well as symptoms of anxiety and depression as an adjunct to CBT (Shirani Bidabadi & Mehryar, 2015). Mindfulness-based cognitive therapy (MBCT) has also been shown to be an effective treatment for people with OCD who have already completed CBT but had some symptoms persist (Key et al., 2017).
Other therapeutic interventions which have been found to be effective on their own include cognitive restructuring (CR) (identifying and rejecting maladaptive thoughts) and detached mindfulness (DM) (identifying and rejecting maladaptive meta-cognitions) (Ludvik & Boschen, 2015).
A single case study has also indicated that acceptance and commitment therapy (ACT) with ERP is effective for improving well-being and reducing OCD symptoms in a patient with OCD (Wheeler, 2017). The treatment of OCD with a short-term psychodynamic therapy (STPP) has also recently been outlined based on the success of STPP in treating anxiety disorders (Leichsenring & Steinert, 2016).
Deep brain stimulation with implanted electrodes has also been shown to be effective, but this is likely to be attempted only with severe, treatment-refractory cases of OCD (Denys et al., 2010).
As for pharmacological treatments, the following have been shown to be effective, including in conjunction with non-pharmacological therapy, as indicated above (Baldwin et al., 2014; Adams et al., 2017; Pignon et al., 2017):
Antipsychotics (as supplements to SSRIs): aripiprazole, haloperidol (only in cases of comorbid Tourette syndrome), risperidone
These are not all of the treatments which have been used for OCD but are some of the most common and most effective treatments used for all kinds of OCD.
Self Help: How To Treat OCD
Since CBT is one of the best treatments for OCD, and CBT can be self-directed, CBT is likely the best way one can treat their own OCD. There are a number of developments that support the self-treatment of OCD, such as self-directed Internet-delivered cognitive behavioral therapy (iCBT) (Rees et al., 2016). Even more useful for modern life is research into app-delivered ERP (Boisseau et al., 2017).
For now, these programs still involve a therapist in some way, and therapist-led programs are still likely to be the most effective. With that said, one can enter a completely self-directed CBT program with resources from around the internet. For example, this 50-page PDF serves as an introduction to CBT, and can help someone start treating their own OCD.
Again, severe cases of OCD are best treated by a therapist in some capacity, but that packet is a good starting point.
The Positive Side Of OCD
Recent research has examined OCD in the context of the “OCD paradox”, the idea that a disorder that leads one to have fewer offspring (if any) could somehow propagate through evolutionary selection (Polimeni et al., 2005). The paper suggests that since OCD has been described for thousands of years, and since the lifetime prevalence of 1%-2.5% exceeds “classic mutation rates”, there must be some evolutionary advantage of OCD. These researchers propose that OCD has not been propagated through individual selection but has rather been propagated through group selection as a “behavioral specialization”.
The authors end by pointing to “checking, washing, counting, needing to confess, requiring precision and hoarding” as potentially advantageous features of OCD that could defend against “predation, disease and starvation” in a group. The paper acknowledges that research has not yet determined whether OCD was propagated through group selection or not, and that even if it was, modern-day OCD remains a debilitating disorder. This idea of OCD as a “behavioral specialization”, however, is an interesting way to think about a disorder that is most often thought of as a burden.
Research also indicates that people with OCD may perform better on challenging tasks than healthy controls, possibly due to “high activation in the frontal and medial networks” of the brain (Ciesielski et al., 2011). This is part of a series of “puzzling findings” that indicate that OCD may help people avoid distraction on challenging tasks. More research needs to be done before any definitive claims can be made, but it is possible that OCD serves some sort of adaptive role when it comes to executive functioning.
A Take Home Message
While we may all experience obsessions and compulsions at certain points, OCD is a serious condition that greatly affects the lives of those who deal with it. It is important that people acknowledge this so that people who struggle with this can be best accommodated. As the last section indicates, though, there may be certain aspects of OCD that are in fact adaptive.
This is just another case of why we should educate ourselves about mental health disorders rather than give in to stigma. If we educated ourselves about disorders, we can help the people around us who live with these disorders without dismissing what they have to offer. In a world where around a third of adults will experience a common mental disorder in their lifetimes (Steel et al., 2014), this education is crucial.
Abramowitz, J.S. (1996). Variants of exposure and response prevention in the treatment of obsessive-compulsive disorder: A meta-analysis. Behavior Therapy, 27(4), 583-600. doi:10.1016/S0005-7894(96)80045-1
Abramowitz, J.S., Deacon, B.J., Olatunji, B.O., Wheaton, M.G., Berman, N.C., Losardo, D., Timpano, K.R., McGrath, P.B., Riemann, B.C., Adams, T., Bjorgvinsson, T., Storch, E.A., Hale, L.R. (2010). Assessment of Obsessive-Compulsive Symptom Dimensions: Development and Evaluation of the Dimensional Obsessive-Compulsive Scale. Psychological Assessment, 22(1), 180-189. doi:10.1037/a0018260
Adams, T.G., Bloch, M.H., Pittenger, C. (2017). Intranasal Ketamine and Cognitive-Behavioral Therapy for Treatment-Refractory Obsessive-Compulsive Disorder. Journal of Clinical Psychopharmacology, 37(2), 269-271. doi:10.1097/JCP.0000000000000659
Baldwin, D.S., Anderson, I.M., Nutt, D.J., Allgulander, C., Bandelow, B., den Boer, J.A., Christmas, D.M., Davies, S., Fineberg, N., Lidbetter, N., Malizia, A., McCrone, P., Nabarro, D., O'Neill, C., Scott, J., van der Wee, N., Wittchen, H.U. (2014). Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: A revision of the 2005 guideline from the British Association for Psychopharmacology. Journal of Psychopharmacology, 28(5), 403-439. doi:10.1177/0269881114525674
Boisseau, C.L., Schwartzman, C.M., Lawton, J., Mancebo, M.C. (2017). App-guided exposure and response prevention for obsessive compulsive disorder: an open pilot trial. Cognitive Behaviour Therapy, 46(6), 447-458. doi:10.1080/16506073.2017.1321683
Challacombe, F.L., Salkovskis, P.M., Woolgar, M., Wilkinson, E.L., Read, J., Acheson, R. (2017). A pilot randomized controlled trial of time-intensive cognitive-behaviour therapy for postpartum obsessive-compulsive disorder: effects on maternal symptoms, mother-infant interactions and attachment. Psychological Medicine, 47(8), 1478-1488. doi:10.1017/S0033291716003573
Ciesielski, K.T., Rowland, L.M., Harris, R.J., Kerwin, A.A., Reeve, A., Knight, J.E. (2011). Increased anterior brain activation to correct responses on high-conflict Stroop task in obsessive-compulsive disorder. Clinical Neurophysiology, 122(1), 107-113. doi:10.1016/j.clinph.2010.05.027
Denys, D., Mantione, M., Figee, M., van den Munckhof, P., Koerselman, F., Westenberg, H., Bosch, A., Schuurman, R. (2010). Deep Brain Stimulation of the Nucleus Accumbens for Treatment-Refractory Obsessive-Compulsive Disorder. Archives of General Psychiatry, 67(10), 1061-1068. doi:10.1001/archgenpsychiatry.2010.122
Goodman, W.K., Price, L.H., Rasmussen, S.A., Mazure, C., Fleischmann, R.L., Hill, C.L., Heninger, G.R., Charney, D.S. (1989). The Yale-Brown Obsessive Compulsive Scale. 1. Development, Use, and Reliability. Archives of General Psychiatry, 46(11), 1006-1011. doi:10.1001/archpsyc.1989.01810110048007
Herren, J., Freeman, J., Garcia, A. (2016). Using Family-Based Exposure With Response Prevention to Treat Obsessive-Compulsive Disorder in Young Children: A Case Study. Journal of Clinical Psychology, 72(11), 1152-1161. doi:10.1002/jclp.22395
Key, B.L., Rowa, K., Bieling, P., McCabe, R., Pawluk, E.J. (2017). Mindfulness-based cognitive therapy as an augmentation treatment for obsessive-compulsive disorder. Clinical Psychology & Psychotherapy, 24(5), 1109-1120. doi:10.1002/cpp.2076
Kose, L.K., Fox, L., Storch, E.A. (2018). Effectiveness of Cognitive Behavioral Therapy for Individuals with Autism Spectrum Disorders and Comorbid Obsessive-Compulsive Disorder: A Review of the Research. Journal of Developmental and Physical Disabilities, 30(1), 69-87. doi:10.1007/s10882-017-9559-8
Leichsenring, F., Steinert, C. (2016). Psychodynamic therapy of obsessive-compulsive disorder: principles of a manual-guided approach. World Psychiatry, 15(3), 293-294. doi:10.1002/wps.20339
Ludvik, D., Boschen, M.J. (2015). Cognitive restructuring and detached mindfulness: Comparative impact on a compulsive checking task. Journal of Obsessive-Compulsive and Related Disorders, 5(1), 8-15. doi:10.1016/j.jocrd.2015.01.004
Meyer, V. (1966). Modification of expectations in cases with obsessional rituals. Behaviour Research and Therapy, 4(1-2), 273-280. doi:10.1016/0005-7967(66)90083-0
Olatunji, B.O., Davis, M.L., Powers, M.B., Smits, J.A.J. (2013). Cognitive-behavioral therapy for obsessive-compulsive disorder: A meta-analysis of treatment outcome and moderators. Journal of Psychiatric Research, 47(1), 33-41. doi:10.1016/j.jpsychires.2012.08.020
Ong, C.W., Clyde, J.W., Bluett, E.J., Levin, M.E., Twohig, M.P. (2016). Dropout rates in exposure with response prevention for obsessive-compulsive disorder: What do the data really say? Journal of Anxiety Disorders, 40(1), 8-17. doi:10.1016/j.janxdis.2016.03.006
Pauls, D.L., Abramovitch, A., Rauch, S.L., Geller, D.A. (2014). Obsessive-compulsive disorder: an integrative genetic and neurobiological perspective. Nature Reviews Neuroscience, 15(6), 410-424. doi:10.1038/nrn3746
Pignon, B., du Montcel, C.T., Carton, L., Pelissolo, A. (2017). The Place of Antipsychotics in the Therapy of Anxiety Disorders and Obsessive-Compulsive Disorders. Current Psychiatry Reports, 19(12), 103. doi:10.1007/s11920-017-0847-x
Polimeni, J., Reiss, J.P., Sareen, J. (2005). Could obsessive-compulsive disorder have originated as a group-selected adaptive trait in traditional societies. Medical Hypotheses, 65(4), 655-664. doi:10.1016/j.mehy.2005.05.023
Rees, C.S., Anderson, R.A., Kane, R.T., Finlay-Jones, A.L. (2016). Online Obsessive-Compulsive Disorder Treatment: Preliminary Results of the "OCD? Not Me!" Self-Guided Internet-Based Cognitive Behavioral Therapy Program for Young People. JMIR Mental Health, 3(3), e29. doi:10.2196/mental.5363
Sánchez-Meca, J., Rosa-Alcázar, A.I., Iniesta-Sepúlveda, M., Rosa-Alcázar, Á. (2014). Differential efficacy of cognitive-behavioral therapy and pharmacological treatments for pediatric obsessive-compulsive disorder: A meta-analysis. Journal of Anxiety Disorders, 28(1), 31-44. doi:10.1016/j.janxdis.2013.10.007
Shinmei, I., Kanie, A., Kobayashi, Y., Nakayama, N., Takagishi, Y., Iijima, S., Takebayashi, Y., Horikoshi, M. (2017). Pilot study of exposure and response prevention for Japanese patients with obsessive-compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders, 15(1), 19-26. doi:10.1016/j.jocrd.2017.08.002
Shirani Bidabadi, S., Mehryar, A. (2015). Music therapy as an adjunct to standard treatment for obsessive compulsive disorder and co-morbid anxiety and depression: A randomized clinical trial. Journal of Affective Disorders, 184(1), 13-17. doi:10.1016/j.jad.2015.04.011
Behavioral activation (BA) is a therapeutic intervention that is often used to treat depression.
Behavioral activation stems from a behavioral model of depression that conceptualizes depression as a consequence of a lack of positive reinforcement. BA is highly customizable and is a very personal treatment plan.
This article will cover what BA is, the behavioral model it is based on, and how to implement BA as a treatment plan, including some of the techniques used in BA.
The Positive Psychology toolkit is a science-based, online platform containing 190+ exercises, activities, interventions, questionnaires, assessments and scales.
What is Behavioural Activation (BA) And How Is It Used To Treat Depression?
Behavioral activation (BA) is “a structured, brief psychotherapeutic approach that aims to (a) increase engagement in adaptive activities (which often are those associated with the experience of pleasure or mastery), (b) decrease engagement in activities that maintain depression or increase risk for depression, and (c) solve problems that limit access to reward or that maintain or increase aversive control” (Dimidjian et al., 2011).
The main idea behind BA as a treatment for depression is “to allow patients with depressive symptoms to learn to cope with their negativity” and to “increase positive awareness through the re-development of personal goals in the form of short, medium and long term life goals” (Chan et al., 2017).
In other words, BA is a type of therapeutic intervention (most often used to treat depression) that focuses on behavioral changes in a client’s daily life. BA interventions might involve helping the client plan more activities they actually enjoy doing, helping the client develop their social skills, or just generally having the client track their own emotions and activities. BA is a highly-personalized intervention that targets one’s depression by targeting the behaviors that feed into that depression.
Behaviourism: The Behaviourist Theory Behind BA
Behavioral activation is informed by a behavioral model of depression, such as the one outlined by Lewinsohn & Shaffer (1971). These researchers believed that depression was a behavioral issue (as opposed to a cognitive issue) that arose from a lack of positive reinforcement, particularly in social relationships. Since they subscribed to a behavioral model of depression, the authors believed that the best way to treat depression was to “restore an adequate schedule of positive reinforcement for the individual by changing the patient’s behavior and/or the environment”.
While some psychologists still subscribe to radical behaviorism, most modern behavioral models are not exclusively behaviorist and do include cognitive components. Most modern psychological models in general include both cognitive and behavioral aspects, exemplified by cognitive-behavioral therapy (CBT), perhaps the most common therapeutic treatment today. In fact, behavioral activation has begun to be explored as a component of CBT for disorders beyond depression, such as anxiety (Boswell et al., 2017).
Interestingly, behavioral activation may even be the driving force behind the efficacy of CBT. A study by Jacobson et al. (1996) which found that to be the case is one of the main reasons people are interested in BA today. Specifically, those researchers found that people with depression who completed BA saw as many benefits as people with depression who completed both BA and some cognitive components of CBT.
While behaviorists no longer deny the importance of cognition, they still advocate for behavioral treatments over cognitive treatments, since behaviors are easy to target than thoughts. The paper cited above (Jacobson et al., 1996) indicates that behavioral activation may even be the reason CBT is so effective. Thus, while behaviorists no longer necessarily think that positive reinforcement is the only way to treat depression, they still believe it is one of the best ways.
Applied Behaviour Analysis: Can BA Help Your Client?
Behavioral activation is a type of applied behavior analysis, which is a field of research based on the principles of B.F. Skinner’s work, and particularly his findings that “in a given environmental context, behaviors that produce favorable outcomes will continue to occur through the process of reinforcement and those behaviors that do not produce favorable consequences will decrease over time, or extinguish” (Roane et al., 2016).
One of the strengths of behavioral activation is that it can be customized according to a person’s “values and abilities”, and can also be customized for specific types of MDD, such as comorbid MDD and a personality disorder (Cannity & Hopko, 2017; Kanter et al., 2010). In other words, in almost all cases of depression, some sort of BA intervention is appropriate. One thing to keep in mind about BA interventions is that the therapist must be mindful about their own reinforcement of the client’s behaviors (Pass et al, 2016). That is, the therapist should make sure to reinforce healthy behavior from their client during their sessions.
The Use Of A Behavioural Model For Behavioural Activation
In order to develop a behavioral activation intervention for a client, one must first conceptualize a behavioral model of that client’s depression. Take the case study of a 16-year-old girl named Amy with depression (Pass et al., 2016). In order to begin treating her depression, her therapist interviewed both Amy and her mother in order to figure out what her depression looked like. From their input, the therapist determined that Amy’s depressive symptoms likely stemmed from her father’s recent death, her mother’s recent illness, her symptoms of fatigue, and her increased academic workload.
Her fatigue was of particular interest, as it kept her from positive reinforcement, particularly in her social life. That is, since she felt tired, she would not go hang out with her friends. Since she was not hanging out with her friends, she would feel bad, and this bad feeling would lead her to having low energy levels. This “vicious” cycle is presented here (reprinted from the article), along with an alternative cycle which BA interventions aim to put in place:
BA was ultimately able to help Amy get over her feelings of depression, in part by helping her find more positive reinforcement in her social life. The personalized behavioral model of Amy’s depression conceptualized by Amy, her mom, and her therapist was a crucial aspect of this improvement. The benefits of a behavioral approach (as opposed to a cognitive approach) like this are illustrated by a comment from Amy, as the paper notes that “Amy had stated in her assessment that she wanted something more ‘practical’ than the bereavement counseling she had received previously. She felt that she had already had an opportunity to explore her feelings toward her father’s death, and this was not her aim for the current work”.
10+ Techniques For Behavioural Activation
Some of the techniques used in behavioral activation include (Dimidjian et al., 2011; Lejuez et al., 2001a):
Self-monitoring of activities and mood
Social skill training
Hierarchy construction (ranking how easy certain activities are to accomplish)
Shaping (training healthy behaviors)
Behavior contract (signing a contract with friends and family so that they will only reinforce healthy behaviors)
Life area assessment (determining in which arenas of life one desires success)
More information on some of these techniques can be seen in A Brief Behavioral Activation Treatment for Depression Treatment Manual (Lejuez et al., 2001a), listed at the end of the following section.
5+ Behavioural Activation Worksheets & Activities
If some of the above techniques sound interesting, here are some behavioral activation worksheets which can be used to work through some of those techniques, with the final worksheet actually being a full BA treatment manual:
Positive Activities for Behavioral Activation
This worksheet will help someone figure out some of the activities that they find rewarding, and how rewarding they find those activities. The worksheet simply asks for a list of activities, then asks how rewarding each of those activities is. This worksheet is a good way for someone to figure out which activities they actually find rewarding in life.
Daily Activity Diary
This is a daily activity log that one can use to simply log how they spend their time. It can be used for a week, as it includes each day of the week, and it includes slots for every hour of the day (with two-hour chunks at the beginning and end of each day). One can make their own activity log if they prefer, but this is a good starting point.
Behavioral Activation Worksheet Fun & Achievement
This is a basic activity scheduling worksheet. Activity scheduling helps people follow through on their responsibilities, but also helps people plan more positively-reinforcing activities (such as spending time with friends). As the worksheet states, the best effects are achieved by scheduling a balance of responsibilities and fun activities.
Behavioural Strategies for Managing Depression
The above worksheet is part of a larger packet, and this is that larger packet. Aside from the activity scheduling worksheet, it also includes a more rigid activity schedule that can help someone plan out their days, rather than just plan a few activities for the near future. Besides those two worksheets, this packet also includes information on how behavioral techniques can help depression, and how one can use these behavioral techniques to their advantage. This is a deep resource that can help someone both understand why BA is helpful and start practicing it in their lives.
A Brief Behavioral Activation Treatment for Depression Treatment Manual
Finally, this is an entire treatment manual for a brief behavioral activation treatment for depression (BATD), as outlined by Lejuez et al. (2001b). It can “be used as a complete treatment, or as a component of therapy that may include other therapeutic techniques and possibly medications”. It includes a discussion of BA and BATD as well as justifications for these treatments, and also includes worksheets and other resources to help someone follow a BA program. This manual is deep and will take a while to work through but is likely the most complete resource available for someone interested in BA.
A Take Home Message
Ever since Jacobson et al. (1996) claimed that behavioral activation was the most effective component of CBT, BA has been a treatment of interest for depression. Several papers have since found that BA is indeed an effective way to treat depression, even when that depression is comorbid with another disorder. There is no doubt that BA is an effective way to treat depression, but BA carries with it a unique implication.
A key aspect of BA is positive reinforcement, particularly in social situations. This means that how we respond to the people with depression around us can have major impacts on their mood in the short-term and their health in the long-term. While we all have plenty of things on our mind at all times, we should also keep in mind how we are responding to the healthy and unhealthy behaviors of the ones we love. Reinforcing the healthy behaviors of a friend may just be the key to their recovery from disorders like depression.
Boswell, J.F., Iles, B.R., Gallagher, M.W., Farchione, T.J. (2017). Behavioral Activation Strategies in Cognitive-Behavioral Therapy for Anxiety Disorders. Psychotherapy, 54(3), 231-236. doi:10.1037/pst0000119
Cannity, K.M., Hopko, D.R. (2017). Behavioral Activation for a Breast Cancer Patient with Major Depression and Coexistent Personality Disorder. Journal of Contemporary Psychotherapy, 47(4), 201-210. doi:10.1007/s10879-017-9359-6
Chan, A.T.Y., Sun, G.Y.Y., Tam, W.W.S., Tsoi, K.K.F., Wong, S.Y.S. (2017). The effectiveness of group-based behavioral activation in the treatment of depression: An updated meta-analysis of randomized controlled trial. Journal of Affective Disorders, 208(1), 345-354. doi:10.1016/j.jad.2016.08.026
Cuijpers, P., van Straten, A., Warmerdam, L. (2007). Behavioral activation treatments of depression: A meta-analysis. Clinical Psychology Review, 27(3), 318-326. doi:10.1016/j.cpr.2006.11.001
Dimidjian, S., Barrera, M., Martell, C., Muñoz, R.F., Lewinsohn, P.M. (2011). The Origins and Current Status of Behavioral Activation Treatments for Depression. Annual Review of Clinical Psychology, 7(1), 1-38. doi:10.1146/annurev-clinpsy-032210-104535
Jacobson, N.S., Dobson, K.S., Truax, P.A., Addis, M.E., Koerner, K., Gollan, J.K., Gortner, E., Prince, S.E. (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64(2), 295-304. doi:10.1037/0022-006X.64.2.295
Kanter, J.W., Manos, R.C., Bowe, W.M., Baruch, D.E., Busch, A.M., Rusch, L.C. (2010). What is behavioral activation?: A review of the empirical literature. Clinical Psychology Review, 30(6), 608-620. doi:10.1016/j.cpr.2010.04.001
Lejuez, C.W., Hopko, D.R., Hopko, S.D. (2001a). A Brief Behavioral Activation Treatment for Depression. Behavior Modification, 25(2), 255-286. doi:10.1177/0145445501252005
Lejuez, C.W., Hopko, D.R., LePage, J.P., Hopko, S.D., McNeil, D.W. (2001b). A brief behavioral activation treatment for depression. Cognitive and Behavioral Practice, 8(1), 164-175. doi:10.1016/S1077-7229(01)80022-5
Lewinsohn, P.M., Shaffer, M. (1971). Use of home observations as integral part of treatment of depression - preliminary report and case studies. Journal of Consulting and Clinical Psychology, 37(1), 87-94. doi:10.1037/h0031297
Pass, L., Whitney, H., Reynolds, S. (2016). Brief Behavioral Activation for Adolescent Depression: Working With Complexity and Risk. Clinical Case Studies, 15(5), 360-375. doi:10.1177/1534650116645402
Roane, H.S., Fisher, W.W., Carr, J.E. (2016). Applied Behavior Analysis as Treatment for Autism Spectrum Disorder. Journal of Pediatrics, 175(1), 27-32. doi:10.1016/j.jpeds.2016.04.023
Something I learned the hard way is – it’s time to relax when you don’t have the time.
But what if we don’t listen to our body?
If we continue slowly burning the candle at both ends until we reach physical and emotional exhaustion? Just like the candle itself – we burn out.
And like the parable of the frog who finds himself in a pot of water on the stove – when the water starts boiling he doesn’t notice the slight increase in temperature, as he swims around busily. Until the water reaches unbearable degrees, and without the frog realizing it, he can no longer survive.
Have you ever experienced this slow acceptance of the pressures building around you until everything gets too much and you can no longer cope?
You and an estimated other 8.3 million American adults who were reported to have experienced serious psychological distress in 2017 (“More Americans suffering from stress, anxiety, and depression, study finds”, 2018).
Wouldn’t it be great if we could notice the boiling signs earlier – so we can learn to make a change and turn down the heat?
The World Labor Report, produced by the U.N.’s International Organization, states, “Stress has become one of the most serious health issues of the 20th century and a worldwide epidemic.” (“Workplace Stress”, 2018)
Let’s change the way we approach our management of stress this year with these tips and techniques to keep you swimming peacefully over the coming months.
The Positive Psychology toolkit is a science-based, online platform containing 190+ exercises, activities, interventions, questionnaires, assessments and scales.
What is Stress Management? A definition
Put simply – stress management is a
“set of techniques and programs intended to help people deal more effectively with stress in their lives by analysing the specific stressors and taking positive actions to minimize their effects.” (Gale Encyclopaedia of Medicine, 2008).
Some popular examples you’ve most likely come across include meditation, yoga, and exercise. We’ll explore these in detail below with a range of different approaches to ensure there’s something that works for everyone.
First, let’s set one thing straight… we’re not aiming towards being stress-free all of the time. That’s unrealistic. After all, it’s an unavoidable human response that we all experience from time to time – and it’s not all bad. What we can all aim towards however is experiencing less stress.
Before we dive any deeper into managing stress, let’s cover a quick 101 on stress itself.
What is stress?
Stress is the “psychological, physiological and behavioural response by an individual when they perceive a lack of equilibrium between the demands placed upon them and their ability to meet those demands, which, over a period of time, leads to ill-health” (Palmer, 1989).
Symptoms of stress
Although we all experience stress differently, some common symptoms include:
Why is stress helpful?
Historically stress was our friend. It acted as a protective mechanism that warned us of danger; a natural reaction telling us when to run. This response is now referred to as the “fight or flight” response, or the “stress response”.
It’s believed that stress has remained part of the evolutionary drive because of its usefulness in helping us to survive. Since when it’s used at the right time, stress temporarily increases our awareness and improves physical performance (Van Duyne, 2003).
Why is stress harmful?
Repetitive exposure of the stress response on our body is proven to lead to long-lasting psychological and physical health issues, such as cardiovascular disease, diabetes, anxiety and depression (“How Does Stress Affect Us?”, 2016).
Stress versus burn out
So, what’s the difference between stress and burn out?
Stress is inevitable. Burn out isn’t.
While stress is our response, burn out is the accumulation of excessive stressors over time, which results in unmanageable stress levels.
American psychologist Herbert Freudenberger, first termed the word “burn out” in the 1970s when he referred to the effect of extreme stress and high ideals placed on “helping” professionals, such as doctors and nurses (“Depression: What is burnout?”, 2018).
Today, the word has evolved and is used more broadly to refer to the consequences of excessive stress placed on any individual, no matter their occupation. When we get to the point of no longer being able to cope, we’re referred to as being “burned out”.
This is where stress management comes back in, to avoid the experience of burn out.
14 Facts About Stress & Burn Out
If you’re not yet convinced about the need to prioritize stress management, the below 14 facts will get you over the line:
Stress has been referred to as the “silent killer” as it can silently cause heart disease, high blood pressure, chest pain, and an irregular heartbeat (Chilnick, 2008).
Telogen effluvium is the result of hair loss caused by stress that can happen up to three months after a stressful event (McEwen, 2003).
Stress is believed to account for 30% of all infertility problems. In women, stress can cause spasms in the fallopian tubes and uterus. In men, it can effect the sperm count and cause erectile dysfunction (Bouchez, 2018).
Researchers have found that stress worsens acne. More so, than the prevalence of oily based skin (Warner, 2002).
Stress can be to blame for weight gain too. The stress hormone cortisol has been found to cause both the accumulation of abdominal fat and the enlargement of fat cells, causing what is referred to as “diseased” fat (Chilnick, 2008).
Correlations have been found between stress and the top six causes of death: cancer, lung ailments, heart disease, liver cirrhosis, accidents, and suicide (“How Does Stress Affect Us?”, 2016).
In children, chronic stress has been found to negatively impact their developmental growth due to a reduction of the growth hormone in the pituitary gland (Van der Kolk, B. et. al., 2007).
The word itself, “stress” stems from the Latin word stringere, meaning “to draw tight” (McEwen, 2003).
In the event of chronic stress, dominant hormones are released into our brain. These hormones are intended for short-term emergencies and in the event where they exist for extended periods they can shrink, impair and kill brain cells (Wallenstein, 2003).
Stress can increase the likelihood of developing blood clots, since the blood prepares itself for injuries and becomes “stickier” (Chilnick, 2008).
Chronic stress can place pressure on, and cause damage to arteries and organs. This occurs due to an inflation in our bodies caused by cytokines (a result of stress) (McEwen, 2003).
Stress is also responsible for altering our blood sugar levels, which can lead to fatigue, hyperglycemia, mood swings, and metabolic syndrome (“How Does Stress Affect Us?”, 2016).
On a positive note, we can reduce our stress levels by laughing. Having a chuckle, lowers the stress hormones, including cortisol, epinephrine, and adrenaline, and strengthens our immune system by releasing positive hormones (Wallenstein, 2003).
More good news, especially for chocolate lovers, dark chocolate has also been found to reduce our stress hormones (Wallenstein, 2003).
7 Tips for Stress Management
Before discussing stress management techniques, there are a few factors we must first consider.
The following 7 tips have been adapted from The American Psychological Association (“Check Out the Stress Tip Sheet”, 2018)to support individuals in getting the best out of a stress management plan:
Understand your stress
How do you stress? This can be different for everybody. By understanding what stress looks like for you, you can be better prepared and reach for your stress management toolbox when needed.
Identify your stress sources
What causes you to be stressed? Be it work, family, change or any of the other potential thousand triggers.
Learn to recognize stress signals
We all process stress differently so it’s important to be aware of your individual stress symptoms. What are your internal alarm bells? Low tolerance, headaches, stomach pains or a combination from the above‘Symptoms of stress’
Recognize your stress strategies
What is your go-to tactic for calming down? These can be behaviors learned over years and sometimes aren’t the healthy option. For example self-medicating with alcohol or overeating.
Implement healthy stress management strategies
It’s good to be mindful of any current unhealthy coping behaviors so you can switch them out for a healthy option. For example, if overeating is your current go to, you could practice meditation instead, or make a decision to phone a friend to chat through your situation. The American Psychological Association suggest that switching out one behavior at a time is most effective in creating positive change.
Make self-care a priority
When we make time for ourselves, we put our well-being before others. While this can feel selfish to start, like the old plane analogy we must put our own oxygen mask on before we can help others. This is also true for effective stress management. The simplest things that promote well-being, such as enough sleep, food, downtime and exercise are often the ones overlooked. Make time for you.
Ask for support when needed
If you’re feeling overwhelmed reach out to a friend or family member you are comfortable talking to. Speaking with a healthcare professional is also an effective way of reducing stress, learning new strategies and preventing burnout.
For more tips about stress management check out these renowned books.
13 Different Stress Management Techniques & Strategies
While there are a lot of things we should be doing less of today, here is the list of things we should be doing more of.
These techniques have been categorized into three groups:
Action Orientated Approaches: used to take action to change a stressful situation
Emotion-oriented approaches: used to change the way we perceive a stressful situation
Acceptance-oriented approaches: used for dealing with stressful situations you can’t control
Action-oriented approaches allow you to take action and change the stressful situation.
As Nelson & Hurrell said:
“Stress is inevitable, distress is not”
1. Be assertive Clear and effective communication is the key to being assertive. When we’re assertive we can ask for what we want or need and explain what is bothering us. The key is doing this in a fair and firm manner while still having empathy for others. Once you identify what you need to communicate you can stand up for yourself and be proactive in changing the stressful situation. You can read more about how to be assertive here.
2. Reduce the noise
Switching off from technology and the constant stimuli thrown at us hourly, is an important way to slow down. How often do you go offline?
Make time for some quietness each day and you’ll notice how all those seemingly urgent things that we feel we need to do, become less important. Plus the to-do list will always be there. Remember – recharging is the most effective way of tackling stress.
3. Manage your time
If we let them, our days will consume us. Before we know it – the months have become overwhelmingly busy. When we manage our time we prioritize and organize our tasks creating a less stressful and more enjoyable life.
You can learn more with these tips about time management here.
4. Creating boundaries
Boundaries are the internal set of rules that we create for ourselves. They outline what behaviors we will and won’t accept. Healthy boundaries are essential for a stress-free life. When we have healthy boundaries we respect ourselves and take care of our well-being by clearly expressing our boundaries to others.
Watch this video to help establish healthy boundaries:
Stress Video Info Course Part 8: Setting Boundaries To Reduce Stress - YouTube
5. Get out of your head
Sometimes it’s best not to even try contending with the racing thoughts. Sometimes you just need a break. Distract yourself. Watch a movie, phone or catch up with a friend or do something positive that you know takes your mind off things.
Emotion – Orientated Approaches
Emotion-oriented approaches are used to change the way we perceive stressful situations.
In the words of William James:
“The greatest weapon against stress is our ability to choose one thought over another”
6. Affirmations and imagery
The power of positive imagery and affirmations is now scientifically proven to increase positive emotion.
How? When you think of a positive experience, your brain perceives it to be a reality.
So, replace those negative thoughts with positive statements and challenge and change the way you see and experience the world.
7. Cognitive Restructuring In the mid 1950’s psychologist Dr. Albert Ellis developed what is referred to as cognitive restructuring, a technique for understanding negative emotions and challenging these sometimes incorrect beliefs that cause them. Cognitive restructuring is a key component of Cognitive behavioral therapy (CBT). More about CBT here.
8. ABC Technique
The ABC technique was also originally created by psychologist Dr. Albert Ellis and was later adapted by Martin Seligman.
The letters ABC stand for; A – adversity, or the stressful event. B – beliefs, or the way that you respond to the event. Then C – consequences, the result of your beliefs lead to the actions and outcome of that event.
Essentially, the more optimistic your beliefs, the more positive the outcome.
More information about this technique and how you can implement it here:
The ABC Technique of learning to think more optimistically - YouTube
Acceptance-oriented approaches are useful in stressful situations that you cannot control.
Epictetus, the Greek Philosopher had it right when he said:
“Men are disturbed not by things but by the views they take of them”
9. Diet and Exercise
You’ve heard it before – but you are what you eat. Be mindful of having a balanced and healthy diet. Making simple diet changes, such as reducing your alcohol, caffeine and sugar intake is a proven way of reducing anxiety.
Another guaranteed way to reduce stress is exercise. It’s proven to also be as effective as antidepressants in relieving mild depression.
So get moving.
10. Meditation and physical relaxation
Use techniques such as deep breathing, guided visualizations, yoga and guided body scans to relax the body.
Some examples for you to try out are included below.
11. Build resilience
Resiliency is our ability to bounce back from stressful or negative experiences.
To simplify, resilient people accept that the situation has occurred, they learn from what transpired and then they move on.
More about resiliency, along with some worksheets and activities can be found here.
12. Talk it out
Don’t block it all inside. Talk to someone close to you about your worries or the things getting you down. Sharing worries is halving them.
And, most of our worries sound a lot less worrisome when we say them out loud.
If you don’t feel up to sharing, writing them down is also a great way to release them or by engaging an independent professional. There are plenty of services available, including free services, which you can quickly google to find what’s available in your city.
Getting a good night sleep is fundamental for recharging and dealing with stressful situations in the best possible way. While it varies from individual to individual, on the exact amount of sleep needed, an uninterrupted sleep of approximately 8 hours..
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