In my practice as a clinical psychologist I routinely see clients with an unhelpful thought pattern. It often revolves around seeing an example of a person who has a more dire situation than themselves.  

Simply turn on the television and we see people across the planet experiencing war, famine, traumas, deprivation, oppression, the list goes on. There are a number of variations for this form of self-torment.

I have nothing to complain about, other people in the world have it so much worse than me.

The client then looks at their own life and says “I have nothing to complain about, other people in the world have it so much worse than me.” Now… if this thought process helped a person to increase their empathy for others, practice gratitude for the positive aspects of their lives.

And possibly even prompt action to address the injustices and disparities in the world then I might say that this could be a helpful perspective. What I often see is clients then use the pain and suffering of others as a means to put themselves down for also having pain and suffering in the first place.  

“How can I feel bad about anything given that others have it so much harder than I do?”. I must be a terrible, ungrateful, awful, horrible person that I have so much and am still whining about my pain.

This person has now entered into a less than helpful thought process.  Here are the ways I  help my patients  out of this particular hole. A Cognitive Distortion traveling with Finn (illogical thought pattern) that they might be engaging in is called Minimization.  

We shrink our pain away by comparing it to someone who potentially has it much worse.  The problem with this thinking is that minimizing our pain could mean that we are actually repressing or denying it.  

For example saying “I’m not supposed to have this pain” and then trying to drag a heavy load without taking the time to look and see what it might be about. Another way of looking at this thought pattern is engaging in a process of Invalidation.  

Almost as though what we are saying to ourselves is “others are in so much more pain than me, that means that my pain doesn’t count, I can’t acknowledge it or even look at it.”  What I’m getting after here is that we  need to be more judicious about how and when we compare ourselves to others.  

If you are in pain, you are in pain.  

The acknowledgement of other people’s pain will not take yours away.  Shaming yourself for having pain in the first place only complicates the issue.  What I encourage instead is to have a “right size” perspective on your pain.  

Many people suffering with anxiety, depression, panic, relational issues, alcohol/substance abuse, etc indeed have concerns and problems. Those problems don’t just go away because “others have it worse.”

Making and taking the time to sit with your struggles allows us to address these concerns, look for their sources and look for methods of healing the pain.  I would encourage taking a self-validating perspective.

Learn to acknowledge if you are in pain that this pain may not be to the degree of others, but it is still true that you are worthy of care and attention. Taking the time to heal yourself and get right, will position you all the better to have the energy.

And gusto to get out there and address some of the wrongs in the world. And just for fun, let me also state that unhelpful comparisons also swing the other way.  

A person can cultivate a sense of false confidence if not arrogance in themselves if they walk around constantly looking for examples of others who are worse than themselves. There can be a short ego boost that might come witnessing someone else’s failure or struggle.

But this also cultivates a habit of needing to see others fail in order to feel good about ourselves.  I would encourage a balanced perspective that would help cultivate acknowledgement and validation of one’s own struggles.

AND a sense of gratitude for the good things that we have in life. I have dedicated my professional life to helping people struggling with these and many other concerns.  

If you would like a free 15 minute consultation where we can discuss your situation, please click on this “link” and send me a message or call 619-414-0042.  

All the best,

Dr. Chad K. Cox PsyD
Licensed Psychologist PSY23320
San Diego, CA

Struggling with depression, anxiety, panic? Here is one Psychologist’s framework that helps with these issues and many more.

Early in my training as a clinical psychologist, I took a course on Cognitive-Behavioral Therapy. In this class, I was presented with a theoretical framework that would dramatically affect my professional development and views on what motivates people towards unhelpful versus healthy activities. I nearly always present this model to the clients that I am assisting and it greatly informs my thinking while providing care. Please note that within the research on Cognitive Psychology, there are many different perspectives and models available. this approach is one of many that attempts to understand the nature of psychological struggles and how to find relief. Below you will see the model followed by a brief description of the components. In my use of Cognitive Behavioral Therapy, I’ve found great utility in this conceptualization, and I hope that it might help you as well.

S.T.E.B – Situation, Thoughts, Emotions Behaviors

The Situation is the external component of the model. Situation refers to the setting, environment or external stimuli that is presented to a person. A person can use memory and visual imagery to help to conjure trenbolone hexahydrobenzylcarbonate the details of the context or event.

Examples of Situations include:

• Saturday night at home alone
• Your boss asks you to stay late at work
• You do not get back a text as expected from a friend
• A car suddenly cuts you off on the freeway

Thoughts are the next step in this model. Situations will evoke different perceptions and interpretations regarding the events. Thoughts refer to the ongoing “parade” of words, memories, images, perceptions that are constantly streaming through one’s mind. Most of our thinking is on a subconscious level. Effort is often required to develop greater mindfulness and become more aware of this thought process. When identifying, I strongly encourage writing down or communicating these thoughts. One can also start to identify patterns of thought that may not be accurate or helpful.

Examples of Thoughts Include:

• “Another night of nothing to do.”
• “Why does he hate me so much?”
• “They must not really care about me.”
• “That person is a complete idiot!”

This model then presents a direct connection from Thoughts to one’s Emotions. Emotions, such as, refer to the internal feelings and sensations associated with our experience. Similar to thoughts, emotions can often happen outside of conscious awareness. To help identify the emotional experience, I often encourage clients to use their emotional vocabulary. This refers to finding a word that approximates or resonates with the experience. This vocabulary can range from straightforward terms such as mad, sad, glad, like/dislike to more complicated verbiage such as dysphoric, ennui, confused, tempted. Using some of the following terms can help improve your awareness of your feelings and almost automatically conceptualize how to address the emotion.

Examples of Emotions include:

• Depressed, Lonely.
• Singled out, Angry.
• Ignored, Sad.
• Anger, Enraged.

Behaviors, such as , refer to the physical manifestation of emotional energy and pertain to observable actions that the body engages in. Behaviors can also encompass situations where a person acts with restraint or manages to avoid participating in an action. Individuals often carry out behaviors in an automatic and unconscious manner. Becoming more mindful of the extent and duration of behaviors can contribute to addressing the decision-making process.

Examples of Behaviors Include:

• Staying on the couch for hours on end.
• Remaining quiet, complying without push back.
• Repeatedly checking phone without sending a message
• Yelling, screaming or honking the horn.

In my approach to Cognitive Behavioral Therapy (CBT), a good amount of work is used to bring a client’s awareness to the four components of the S.T.E.B model. Though there are different theoretical perspectives, I like to emphasize how behaviors are driven by emotions, how what we feel relates to the beliefs and stories we tell ourselves and that our thoughts can be shaped and modified.
In following blog posts, I will dive into more detail for the S.T.E.B model and how this can help to decrease depression, anxiety, cravings, panic and many other uncomfortable states. When using Cognitive-Behavioral Therapy techniques, the hope is to develop more insight into unhelpful thoughts, exaggerated emotions and unwanted behaviors. When practiced, CBT tools and tricks can provide you with greater relief, satisfaction and meaning.

If you would like to learn more about my approach to Cognitive-Behavioral Therapy and how it could help with depression, anxiety, panic or other conditions please call 619-414-0042 or send me a message to schedule a free consultation.

All the Best,
Dr. Chad K. Cox PsyD
Licensed Psychologist PSY23320
San Diego, CA

“Are you struggling with stress, anxiety and depression in the context of demanding employment or career?”

There are times when depression or anxiety contain an uncomfortable but useful message. These feelings can present an underlying need or want that demands to be addressed. For many of the clients I assist in psychotherapy, these painful emotional states arise in the context of their employment. Work can be a source of satisfaction, purpose and meaning. When dialed in, one’s occupation provides a strong sense of accomplishment and direction. However, the difficult mood state may be trying to get your attention to help you address incongruence between your well-being and work.

As you progress in your career you may find that success breeds increasing responsibilities. Promotions may on the surface look good but may lead to an increase in obligation and stress. If the job itself has not changed, depression may be a sign of one’s evolving preferences and interests. Other times the clients I work with find events such as new relationship or starting a family can lead to an attitude change towards work. Regardless of its source, a persistent emotional energy may be trying to get your attention for a good reason.

As you progress in your career you may find that success breeds increasing responsibilities. Promotions may on the surface look good but may lead to an increase in obligation and stress. If the job itself has not changed, depression may be a sign of one’s evolving preferences and interests. Other times the clients I work with find events such as new relationship or starting a family can lead to an attitude change towards work. Regardless of its source, a persistent emotional energy may be trying to get your attention for a good reason.

Initially, anxiety and depression may seem like mysterious uncomfortable feelings that arise and persist in one’s lives. They may initially seem incongruent with your lifestyle. On the surface, areas such as financial stability and job security may seem fine. There could be no obvious explanation but the feelings persist in bringing you down. Often clients engage counseling when these feelings start to affect performance, functioning or enjoyment with their lives. It takes courage to reach out and ask for assistance.

It takes strength to listen to this voice and perceive if a change is needed. In managing depression and anxiety in the context of work, there are many approaches a therapist can present but most of them will initially induce a sense of nervousness. Honoring your voice will not always be easy. Making changes or setting boundaries will likely be met with internal or external resistance. Such changes could include dedicating more time to self-care or relationships, readdressing ones work prioritization such as taking on fewer projects or tackling an intense but short-term approach to finishing a work project that has been dogging you for too long. The process of psychotherapy can help you identify the work issues that activate difficult emotions and foster strategies to resolve these effectively. Balancing work responsibilities with personal well-being might be challenging but therapy can be a highly effective format for one who wishes to seek clarity and direction.

Send me a message if you would like to learn more about how I can help manage stress and anxiety in the context of your career or if you have any questions.

Hi Everybody, Dr. Cox here. I wanted to take a minute here to discuss what is probably my favorite cognitive distortion: The Should Statement. In practicing Cognitive Behavioral Therapy, much of the technique involves identifying and then modifying unhelpful or inaccurate thoughts. If you search online you will find many different lists of these prototypical distortions. My personal favorite list comes from the book Feeling Good by David Burns where he describes Should Statements as, “You try to motivate yourself with shoulds and shouldn’ts, as if you have to be whipped or punished before you could be expected to do anything.” Should’s have a number of synonyms (Must, Ought, Supposed, Need) and you might relate to a few to of the thoughts below:

When addressing “shoulds” the frequent rebuttal that I will get from clients is, “aren’t Should Statements helpful? Don’t they provide a moral backstop or give you a jolt to live with in your values? Aren’t these statements pointing us towards a better or higher self?”

The difficulty with this thinking is that it puts an externalized or idealistic perspective in charge. The mind will likely hear these statements as well intentioned but they still feel like a command that you “MUST” engage in a certain action and you will not be “OK” until you do so. A problem here is that most people do not like to be controlled or told what to do. There can be an immediate visceral rebellion vs the demand. But if the issue is not addressed, the person stays in a sort of mental purgatory where they hear the should in their head but are fighting against the self-disrespect of mindless compliance.

But not to worry, there are techniques that will help you address these should statements. One of them is the simple act of changing the language behind the statement. This simple act can assert your own sense of autonomy and decision making. In modifying the language from the above statements, you may already feel how they are more congruent and grounding:

The new language of these statements still tell you the truth. If there is a struggle in your life then it is congruent and validating to affirm that it is indeed difficult. When we deliver a message to ourselves that not only do we have a problem but also that we should have addressed it years ago, we feel an extra level of pressure and agony that often deepens our despair. This can lead to hopelessness and procrastination. Changing the language not only acknowledges the problem but also presents you with the opportunity to find a realistic and practical way of moving forward. Addressing these challenges will probably not be easy (who doesn’t like cake?) but I believe you are more likely to succeed in acceptance of the issue and then look for incremental steps that can move you forward. If you want to take an excessively positive perspective, you can try to find the excitement and anticipation in resolution of these issues through your persistent efforts. Imagine how you would like to feel physically from consistent gym attendance, the first day of that new job or feeling close and connected to your partner again. For most people that might be a bit much, so instead they learn to focus on one small step at a time.

I hope you are well and “should” you want to have a free consultation regarding my psychotherapy services, please send me an email or give me a call at 619-414-0042.

All the Best, Dr. Chad Cox

One of my absolute favorite books is called Dhamapada: The Sayings of the Buddha. It is a very small, pocket sized book but it presents very concise descriptions of how to work towards peace, love and kindness. The following is a brief excerpt from that powerful little book. Enjoy, Dr. Cox

Dhamapada – The Sayings of the Buddha

Choices

We are what we think.
All that we are arises with our thoughts.
With our thoughts we make the world.
Speak or Act with an impure mind
And trouble will follow you
As the wheel follows the ox that draws the cart.

We are what we think.
All that we are arises with our thoughts.
With our thoughts we make the world.
Speak or act with a pure mind
And happiness will follow you
As your shadow, unshakable.

“Look at how he abused me and beat me,
How he threw me down and robbed me.”
Live with such thoughts and you live in hate.
“Look how he abused me and beat me,
How he threw me down and robbed me.”
Abandon such thoughts and live in love.

In this world
Hate never yet dispelled hate
Only love dispels hate.
This is the law,
Ancient and inexhaustible.

As our society struggles with the effects of the COVID-19 infection, more and more people are exploring the option of online counseling. The general use of video chat services are expanding rapidly and this includes health care and psychotherapy. Though it may not be effective in all situations, online counseling offers some advantages over traditional, in person face-to-face therapy. We will explore some of these below.

Flexibility:

With online counseling, your appointment and the schedule of the counselor can be more quickly altered or modified. Should you need to move a session by a few hours or even move it to the next day this is easier to accommodate as there are not the same concerns about schedules and office space.

The Comfort of Your Home:

Online counseling allows you to have sessions in the comfort of your own home. You can pick a room or couch that is cozy or convenient and this can facilitate a greater sense of safety and ease that you might not have when attending a counseling office.

Counseling at your Office:

Sessions might even be possible during your office hours. On occasion people have occupations where they have the privacy necessary to attend online counseling sessions. If available, this could be in your private office or a conference room. You would want make sure that you will be uninterrupted during these sessions. You also may need to give yourself some time for emotional processing as counseling sessions often bring up strong emotions. I have had a number of clients who have attended productive sessions from work and felt a greater sense of efficiency in not having to take much time away from their busy days.

There are also drawbacks and disadvantages for online counseling but I have found (to my pleasant surprise) that this format has been a positive and effective means of providing therapeutic services. If you would like to learn more about my practice, call for a free phone consultation P. 619-414-0042.

All the Best, Dr. Cox