Reviews: Therapy apps

The core principle of cognitive reconstruction is to find your preferred version of reality, which is based on your own values, and then act on your brain to change how you view the world so you can change how you act in the world. 

What this looks like: I want to be less controlling of situations where my top value in the situation isn't to influence or guarantee a specific outcome.  

Specifically: When interacting with my partner, treating them like the friend I value and love is more important than picking out the right movie or making sure dinner includes the pine nuts that are specified in the recipe. 

So you can do this cognitive reconstruction or reframing with a therapist, you can practice it on your own, and you can even find an app or two that can help (which, if you're a tech enthusiast like me, is exciting). 

The Wish Outcome Obstacle Plan is a poorly named app that attempts to be cognitive therapy in a box. It's fun to try but not to continue.

WOOP

The first App is called Wish Outcome Obstacle Plan and is for Android and iOS.  It describes itself as : "the systematic way to motivate yourself. Through the app, you will learn the self-regulatory technique Mental Contrasting with Implementation Intentions, also called Wish Outcome Obstacle Plan".  In practice it is a decent yet incomplete method of helping you plan for and deal with the problems that keep people from achieving personal goals.  It has a lot of focus on mindful meditation and envisioning your preferred outcome. It's just not fun.  The process gets a bit stale after a few repetitions, even though you know that what you are working on is very important.  This is an interesting phenomenon.  Should change, especially self-guided change, be fun and self-rewarding? It certainly seems as if it would help. 

If you do get into the app, you will find it to be good at targeting cognitions more than behavior, which I think is a very good sign.  Behavior will change after the cognitions and emotional content change. 

Just like having this guy as your therapist

Annoyster (iOS) and Randomly Remind Me (Android)

These two are lumped together here because they effectively work in the same manner.  They are designed as reminder tools, but because they have the ability to show these reminders randomly, they can be wonderful tools as a cognitive therapy add-on or even as a self-help stand alone program. 

The basic functioning of the apps are the same. You set up a schedule by telling it how often and what you want reminded of.  I can have it remind me to spend time thinking about how I want to be kind to those I care about and I can set it to tell me 8 times during the day.  Randomly Remind Me also lets you keep track of how often you actually follow through on any prompts, such as preferred cognition repetitions or kindness gestures.  

The process with cognitive change is not complicated, but catching yourself in the right situation is very difficult because when you are agitated or otherwise stuck in a negative emotional situation you instinctively resort to older, more practiced habits.  Either of these apps have the ability to catch you in those situations and help you build new experiences.  

Personally I have had good success with Randomly Remind Me, though I rarely have more than one change active at any time.  It is really wonderful to see it pop up and to be able to make small cognitive changes right then and go back to doing other things.  

Any of these three apps can be very useful, especially if you are working with a therapist to implement changes to your thoughts.  Some therapists want you to do quite a lot of work outside the office and having a reminder tool gives you more likelihood of being able to make your practice count much more than if you set aside time only when it is convenient to you (which almost always means when your negative emotions and cognitions are not activated). 

In combination with these I have also created a practice repetition device that operates much like a prayer rosary, which brings up a very interesting conversation about what the similarities between prayer and cognitive therapy end up being once you boil each down into it's constituent parts. 

But that's content for another post. 

When Moving Is the Answer

I was pointed to an emotional piece on self-development and emotional decision making by Bethany Suckrow called "When Moving is Not the Magic Solution." It's a quick read, and seems to be talking about a very real concept: trying to change external factors to facilitate internal change. She thinks it didn't work out how she planned, which may be right. I think it worked out exactly how she needed it to.

I like that the article speaks indirectly about the predictive nature of our brains. In two places she refers to the narrative being much more beautiful than the actuality.  Her brain (and, she expects that of the reader as well) had filled in the story's gaps with positive predictions. She didn't state this directly, maybe because she doesn't know what's happening, but what she's referring to is normal reaction: the brain of a healthy adult tends to fill gaps in information with happy, positive projections. The brains of depressed individuals tend to be more accurate in their predictions. Spend some time chewing on that.  

Brains (especially those influenced by Facebook) also tend to share what makes our situation look positive. You can watch the author try to be honest about what happened in her situation, but she actually spends only a tiny amount of time describing the negatives and only in very general terms. It's as if her healthy brain is still monitoring and filtering what she shares, so as to keep her focussed on the positive aspects of her life. 

Suckrow tried to present the reality of what moving means, but I think she missed the real issues, those being emotional. Even the hardships she talks about are as damaging emotionally and as difficult to get over internally as they are externally.  It's really interesting to see that her conclusion is emotional even though she speaks only about functional changes and problems ("my mom had died"). She seems to still be caught in the trap of presenting empirical problems and information, even when she knows the struggle is emotional. Again, her brain seems to be in a healthy place, protecting her from both internal and external judgement about her emotional struggle in the situation. 

“Lies don’t need an aeroplane to chase you down”

— Avett Brothers - The Weight of Lies

Really lovely stuff. It's this stuff that makes me think that she got exactly what she needed: the space to fail, survive and prove to herself that her life isn't dependent on her mother or the stability of what she had in Chicago; that it's really dependent on her own work and actions. I think she found some beautiful conclusions, and I think we could enrich it more.

What if we changed: "Wherever we go, there we are." 

Into: We can be, wherever we are.

Bethany thinks it this way, "Each of us absolutely have permission to pursue lives that make us content and fulfilled. But there is no magic formula, no reset button, no shortcut to a better version of our lives. There’s no quick leap into the future where everything is fine and nothing hurts." I don't agree with this. 

“Given sufficient internal and external motivation for the change, people are able to move themselves internally without having to move anywhere physically. ”

I think that people who dare to take risks and seek more true answers (and to follow the path these answers necessitate) are able to make dramatic changes quickly. Given sufficient internal and external motivation for the change, people are able to move themselves internally without having to move anywhere physically.  It may be tough for her to realize, but she actually got exactly the change she needed and should have expected if she had ignored her healthy brain and looked at realistic expectations. 

So we need to decide if it's more important to be realistic, to post pictures of how our lives really happen or is it better to keep a presentation that's focused on how we want things to appear, how we want our lives to be.  Our healthy brains know the answer they want. 

Not that it's perfect, but it's a good song to accompany the post. 

Our Self Constructed World

I spent some time trying to figure out the proper phrasing for what it is we are trying to accomplish with the combination of Post-Modern Narrative Therapy, the emerging science of Neural Plasticity development and my own predilection for Motivational Interviewing techniques for engagement.  What I came up with was a mishmash of words, all that I felt needed to be crammed into the modality name.  It would be something like:

Heroic Targeted Intentional Revisionist Cognitive Neural Preferred Story Reconstruction. I'm open to suggestions. 

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You can change your past by changing who you know yourself to be

But here is the problem and the opportunity.  I believe that people, when presented with the overwhelming information regarding our own self-creation of the world around us, will choose to work towards a creation of their preferred reality instead of continuing a problem-saturated reality.  But introducing this in therapy is a bit clumsy, much like telling a story and getting kids to come along with you in a game of make-believe. Only in this story the hero is you and it's not make believe, it's self-revision.  

Self-revision is the key component in real cognitive change. It is the result of retelling the stories of your life in a way that reframes them to come in-line with the person you want to be.  Our histories structure our future by forming our beliefs about what we are and what we can accomplish.  We see this technique starting to change the paradigm of treatment in domestic violence and child abuse, as people affected by these problems are called survivors instead of victims.  What are some of the titles you carry?  If these titles are the name tags we wear tightly pinned to our chests, how would you like them to be re-visioned to more accurately reflect who you want to be. 

So-here is where it gets important. How do we free up the activity of the limbic system (blog post for clarification) to allow for more pre-frontal activity, which is what we need for self-recreation.  We need to practice with our active mind in order to convert the new belief into our durable self-concept.  So instead of Cognitive Behavioral Therapy, we are in effect doing Cognitive Identity Therapy.  

Ask a question, post a comment or start a conversation if you want to take this farther.