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. 

What is Neuroplasticity Retraining?

The basics of any positive choice therapy is that you catch unwanted thoughts, focus on a new thought or belief and then try to store that information as new cognitions about the same trigger situation or thought. 

The basics are described visually below.  Let's put anxiety aside for a moment and focus on your brain habits, which are the changeable loops, or filters, we are targeting with neuroplasticity retraining. The trick here is to both catch the loop at the beginning (with the bad thought/trigger) and to intentionally begin cognitive processes (your chosen thoughts) so that over time this new reality becomes what you emotionally respond to. It's a tough process, and we'll coach you through it over the course of our sessions.

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This process will increase overall positivity in your life once you build the skills to catch, process and reprogram input faster than the rate of negativity from the old loops. 

My experience is that clients begin to fully understand this process by trial-and-error at the beginning. Then, once fully understood, the challenge becomes one of finding a trigger during the negative input that will activate the filter process. Remember that "neurons that fire together, wire together" which means we need to find a trigger for the positive filter that coincides with the negative thought. It doesn't work to practice these things separately. 

We could wait for these things to happen naturally, and practice them over long periods of time, but I believe we can make these neurological changes happen a lot faster by setting up some practice!  

To set up a simulation, we will learn to trigger the negative cognition while queueing yourself for the filter. You may call someone while you have a cognitive cue card in your hand or you may set a reminder for yourself so you can think about the anxiety for 3 minutes and then think about your new cognitions for 5 minutes afterwards.  Once this active trigger process has been done for a few cycles, you may notice that when the negative cognition happens, you start to automatically start the filter process. 

The more active approach to neuroplasticity enhancement and retraining helps you figure out a preferred reality, or story, and prime yourself with a lot of self-talk so that you can catch yourself in the act of the problem-flooded cognitions. In this instance, you'll need to figure out some way to pair the negative thoughts with your new, productive thoughts. 

The way this could look is to find something that coincides with the negative thoughts.  For example: When you get to the office, you become anxious about talking to my co-workers.  Maybe you prime yourself by thinking about who you may see first and then pair that person with your new cognition. 

It takes a lot of repetition to create new neural connections or to let old ones become less strong. Also not every trick will work.  But the process of frequently practicing a new, preferred way of thinking will slowly change your brain functioning. It will create a new you. 

The Positive Side of Anxiety

Why does anxiety exist and what is it trying to do for us?

So. First let's set aside Fear.  Fear is like anxiety but (for this conversation) fear relates to anxiety around things that are real.  Anxiety, in this conversation, concerns feelings about events, thoughts or beliefs that do not actually happen, but also do not actually NOT happen. This is the problem with anxiety: you rarely get to prove to yourself that something that makes you anxious isn't going to happen. 

“The positive side of destructive, dysfunctional anxiety is that it lets you know that something isn’t going right and it motivates you to make changes that you otherwise wouldn’t make. ”

Anxiety appears to be an uncomfortable side-effect of our amazing ability to predict the future and plan for our best-possible outcome in that future.  But . . . and this is where it gets fuzzy . . . many articles about anxiety slip into referring to anxiety as the feeling you get before you take a test, which may be somewhat helpful, instead of the feeling that many people have just leaving the house (or insert other daily functional activity here).  

Distressing anxiety is entirely different than Eustressful anxiety.  Dysfunctional anxiety should not be confused with functional, normal, or even peak situationally-appropriate anxiety (fear). 

So if I'm not going to refer to Fear, nor non-dysfunctional anxiety, how do I talk about the positive side of anxiety? The positive side of destructive, dysfunctional anxiety is that it lets you know that something isn't going right and it motivates you to make changes that you otherwise wouldn't make.  It also helps you deflect focus from areas where your control to make change is limited.

Social anxiety and other situational anxieties do a wonderful job of motivating us to change our behavior. The problem with them isn't the motivation, it's usually the direction or object that the anxiety focuses on for the change that's incorrect.  For social anxiety, the issue may not be that someone really is that awful to have around, but it may be that the person with anxiety has to spend more time picking up on social cues that don't come easily to them or to their own need to recover and regain energy away from other people. Motivation=good. Objective=not so good. 

In my practice, I find it very hopeful to speak with someone about their anxiety, because the negative, uneasy, self-destructive thoughts and feelings that they are experiencing help keep them focussed and motivated to make changes. There are so many people in therapy who aren't ready or willing to change. But you out there with anxiety-you are motivated! Someone will come in, work really hard on their problems and even though the anxiety starts to go away, they find that working on their issues is important for their own reasons. Without the anxiety they may not have been forced to make changes. 

So. . . did I dodge the question or try to use a technicality to get out of the obvious: that anxiety isn't positive and even test anxiety doesn't help you do better. It's just a horrible side-effect of our brain not being that great and dropping a topic after it's no longer useful. 

For most anxiety, it actually limits our brain's ability to make cognitive-based decisions about situations, decisions which may lead to better outcomes because they aren't clouded by misdirected motivation. 

Enthrive North here to help sort this mess out with you.

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. 

Why Cooking Helped Make Us Super Primates

The 3 Cs of Preferred Reality Formation

What initially looked like Clickbait on Psychology Today, turned out to be a good article:  

5 Types of Self-Talk That Guide, Heal, and Motivate

The content is quite important, especially the 3C trick to positive neuro-behavioral predictions. 

The 3 Cs are: Catch, Challenge, Change. But while Psychology Today wants you to challenge your irrational beliefs, I think it is more important to catch your "old" or "outdated" thought patterns and change them into your preferred beliefs.  

Catch yourself using a thought process that is problem-perpetuating or problem-flooded, such as "I want to get away from these people that are talking to me and bugging me."

Challenge the reasoning and the source of those thoughts: maybe by calling out the depression for what it is doing to you by thinking or saying "The depression is trying to remove me from people who want to help me by tricking me into wanting to remove myself."

Pretty Picture Because it Helps Make it Easier to Read

Change your thought pattern by replacing it with your preferred reality thoughts and actions: You could fight back against the depression by talking to the person who the depression wanted you to avoid, you could choose to push back by talking to someone you have already identified as supportive and helpful, or you could simply reframe the thoughts in your head: "Depression is a very strong influence right now and I need more practice and support to be able to fight back every time, it's okay that I leave and sleep, but it's not okay for me to let depression trick me into believing these thoughts are okay or from who I know I am." 

You don't have to win every situation to keep pushing back. What you need to do is start reframing thoughts and feelings to fit your new, preferred way of being in the world and keep practicing. Just like practicing almost anything, over time you will notice you are getting better at it.

Neuroplasticity and Narrative Therapy

Using a Narrative Therapy background and orientation, I help clients separate themselves from the problem, to place that problem within a social and cultural context and then to see how their own behavior has really been a way of dealing with and limiting the damage of the problem.  In this way I externalize the situation, changing a depression from being an internal weakness to an external disease that has infected the person.

I spent 8 years in Philadelphia at the Center for the Continuum of Care in the Addictions and the Treatment Research Center through the University of Pennsylvania. We focused on testing low-impact, problem-focused, harm reduction-based methods of treatment.  What I found through that process was that addictions, anxiety, depression and other issues of emotional regulation often are compounded by a person's cognition-behavior feedback system.  Someone believes they have depression, feels they have depression and then starts to identify their behavior as that of someone who "has" depression, instead of that of someone who is fighting depression. Once we have changed a person's orientation to the problem, changing their cognitive responses becomes easier.

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Sagittal Fibers

With the influence of the methods we used at the University of Pennsylvania and my brother's scientific work as a neuroscientist at the University of Colorado, I have developed a system of Neuroplasticity Enhancement and Retraining that allows people the freedom to create a preferred reality by giving them the awareness of their own ability to change their emotions by changing their active thoughts. It is similar to Cognitive Behavioral Therapy but without the messy homework of action.  Instead we do homework of thought practices and of logical exercise. 

In practice though, you should forget what I said above.  All of that junk is nice, but I've found that my real asset is my ability to connect with and join in a person's emotional and spiritual growth.  I really like people and love being a part of their change process. I find that by being very present, very emotionally available and by respecting a person for where they are at the moment I can help them feel the support and acceptance they need to move from that sticky, uncomfortable spot that necessitated reaching out for counseling.