Cognitive Behavioral Therapy for Anxiety and Depression (Session 1 of 6)
1: Opening the Session
Josh, I’m so glad you were able to come in for a visit today.Â JOSH:Â Um hmm.Â AMY WENZEL:
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[00:05] AMY WENZELWhat was it you were hoping to accomplish today in our visit?Â JOSH:Â Um, I just thought it was a good opportunity
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[00:10] JOSHto take care of some of the anxiety issues, or at least talk about it.Â AMY WENZEL:Â Sure.Â JOSH:Â So any opportunity I have, especially because I’m not fullyÂ insured to talk about it with a professional. I usually take up,Â pretty frugal that way.Â AMY WENZEL:Â Yeah. No, it sounds like you’re seizing an opportunity and we’re gonna
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[00:30] AMY WENZELmake the best use of it.Â JOSH:Â Yeah.Â AMY WENZEL:Â That’s terrific. That’s terrific. So I definitely wanna hear moreÂ about the anxiety and then so one of the things that I was hoping to do here today is toÂ hear a bit more specifically what you’re experiencing in terms of anxiety andÂ I saw in here there’s a little bit of depression as well. So we’ll kind of talk about, not only those emotional experiencesÂ that you’re having, but also some of the things going on in your life, the stressers and things that might trigger some of the depressionÂ and anxiety. And as you’re talking I will link what you’re talking aboutÂ to the questionnaire here, to some of the responses that you made on here. And then I’ll also link itÂ to this model right here. This is theÂ cognitive behavioral model that underlies the particular type of therapy that I do, cognitive behavioral therapy.
1 minute 15 seconds AMY WENZEL
[01:15] AMY WENZELAnd this is a way of just really making sense of your emotional experiences and other experiencesÂ in your life. So as you’re telling me about this, we’ll kind of make sense of it in termsÂ of this model so you can start to understand how the pieces get put together.Â JOSH:Â Sure.Â AMY WENZEL:Â How does that sound?Â JOSH:Â Uh, yeah,
1 minute 30 seconds JOSH
[01:30] JOSHthat sounds fine. It looks a good, looks like a pretty textbook model.Â AMY WENZEL:
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[01:35] AMY WENZELTextbook model, you got it. You got it.Â JOSH:Â Very professional.Â AMY WENZEL:Â Good. Good. You know, the other thing I was hoping to doÂ here today was just share a little bit more about what cognitive behavioral therapy’s all about and justÂ hear from you if you think it’s a good match or if there’s some things that you think might pose some obstaclesÂ to some of our work together in the future.Â JOSH:Â Sure.Â AMY WENZEL:Â Sound okay?Â JOSH:Â Yeah.Â AMY WENZEL:Â Okay.Â So tell me a little bit more about the anxiety.Â JOSH:Â Um, my anxiety, I guess a good way
2 minutes 0 seconds JOSH
[02:00] JOSHto track my anxiety would be just like my educational experience.Â Since when I was 18, if you would’ve asked me what I’d be doing now I’d be taking over the world.Â I’m 24. I’ve been in school for six years and I get my bachelor’s degreeÂ in May. And a lot of that, I think about two years into my collegeÂ education I just really developed some sort of anxiety,Â just like this, I wanna call it, almost like a fog in my head where certain things became harder.Â AMY WENZEL:
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[02:30] AMY WENZELHow difficult.Â JOSH:
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[02:35] JOSHThe closer to school related it is, the harder it became.Â AMY WENZEL:Â Okay.Â JOSH:Â Right before I really started getting a lot of anxiety I became involved in a business fraternity.Â And we actually started on campus at ISU. But over the course of two semesters,Â I completely fell out of the group of friends I was with.Â I went from being the social chair to just not showing up.Â I took a semester off and then never went back to the fraternity.Â AMY WENZEL:
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[03:05] AMY WENZELOkay.Â JOSH:Â So I’ve definitely gone down since then but I’ve come back up since then too.Â AMY WENZEL:Â Okay.Â Good to hear that. Good to hear that. So when you started off by saying, boy, when you were 18 youÂ thought you were gonna take over the world, I’m taking that as that you didn’t really have problems with anxietyÂ up until that time. Is that correct?Â JOSH:Â No. Even up until I was maybe like 19 or 20.Â AMY WENZEL:Â 19Â or 20. Like one or two years in.Â JOSH:Â I mean, I was always very educationally
3 minutes 30 seconds JOSH
[03:30] JOSHsound. I always had a lot of ambition. I wasÂ the young entrepreneur on the block, you know?Â AMY WENZEL:Â Oh, really.Â JOSH:Â So yeah, you needed something done around your house, the oddsÂ are you could find me to do it.Â AMY WENZEL:Â Okay. Okay. So you were ambitious. You were entrepreneurial.Â JOSH:Â Very ambitious. Yeah.Â AMY WENZEL:
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[03:45] AMY WENZELOkay. You went to a four year school. Sounds like you were gonna major in business.Â JOSH:Â Yeah. Yeah, I actually went into
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[03:50] JOSHaccounting.Â AMY WENZEL:Â Okay. You went into accounting. And then, so tell me a little bit more
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[03:55] AMY WENZELabout that period when you had the onset of that fog and the anxiety.Â JOSH:Â Um, it was the winter time when I first noticed it.
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[04:00] JOSHI guess looking back now I probably didn’t realize it then. I probably just brushed it off asÂ a seasonal disorder, something like that. I remember telling my grandmotherÂ on the phone about it and she’s, my grandmother’s kind of a close mentor for me,Â and she told me to go to see somebody. And they diagnosed meÂ with just really mild depression and anxiety. But.Â AMY WENZEL:
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[04:25] AMY WENZELOkay, okay. So it sounds like there was no specific trigger.Â JOSH:Â There certainly were a few things in my
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[04:30] JOSHlife. I’m sorry, I was trying to think what the original question was.Â AMY WENZEL:Â Sure.Â JOSH:Â I had a breakup with a high schoolÂ sweetheart. I don’t wanna say that was it. I was living away from home.Â I had that stresser. And I had just moved out of the dormitories into an apartment.Â So there’s the not being cradled by the university anymore.Â AMY WENZEL:Â Okay.Â JOSH:Â And my parents started getting their divorce, which didn’t reallyÂ affect me as much, I don’t know,Â I was away from home. But maybe affected me, I just didn’t realize it.Â AMY WENZEL:Â Okay. Okay.
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[05:05] AMY WENZELSo it sounds like you didn’t have a history of depression or anxiety prior to this period. WhatÂ about anybody that your biologically related to in your family?Â JOSH:
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[05:15] JOSHUm, my mother had, I believe I remember hearing she had post baby depression,Â postpartum depression.Â AMY WENZEL:Â Postpartum depression.Â JOSH:Â And I know she’s had an anxietyÂ attack or two in her life.Â AMY WENZEL:Â Okay.Â JOSH:Â I don’t know too much about her experiences and all. But I knowÂ she’s experienced it in the past. And then of course with the divorce,Â you ask which parent what’s wrong with the other one, they’ll give you a whole list of medical; she’s bipolar,Â she’s this, he’s that.Â AMY WENZEL:Â Sure. Sure. Okay.Â JOSH:Â Most people I’m withÂ would say I’m nothing like my parents.Â AMY WENZEL:Â Okay.Â JOSH:Â Cause I work in a family business.Â AMY WENZEL:Â Oh. Okay.Â JOSH:Â SoÂ they all know my parents.Â AMY WENZEL:Â So the reason I was asking that question about your
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[05:55] AMY WENZELfamily is because I’m trying to put this together now into an understanding of the onset of your anxiety.Â And one of our models of depression and anxiety that we oftentimes useÂ in our field is something called a vulnerability stress model. And a vulnerability could be like a genetic predispositionÂ to depression or anxiety. And one of the ways we know if a person has aÂ genetic predisposition is if they have a family history of depression or anxiety. So you know the way I’m startingÂ to understand this is that you might have this vulnerability and when things are going wellÂ and you’re successful and entrepreneurial, you’re not experiencing any symptoms.
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[06:30] AMY WENZELBut it sounds like you had a trifecta of stress there, a transition between the breakup,Â the moving out of the comfort of the university taking care of you into the apartment,Â and then your parents’ divorce. And so that was a stresser, that really sort of brought that anxietyÂ out or brought it to the next level.Â JOSH:Â Yeah.Â AMY WENZEL:Â Does that resonate with you?Â JOSH:Â Yeah, certainly,
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[06:50] JOSHlike the perfect storm.Â AMY WENZEL:Â Perfect storm. You got it. So then you experienced
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[06:55] AMY WENZELit as fog, you said.Â JOSH:Â I just didn’t wanna do anything with anyone.
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[07:00] JOSHYou have those classes in college where you go every day. You have the classes where you go Tuesday andÂ Thursday and… I mean, I would just be sitting in classÂ saying, “Okay, after this next slide I’m gonna leave.” Cause I turned to my homework, I don’t need to be in class.Â And then it just got worse from there.Â AMY WENZEL:Â Okay.Â JOSH:Â It’s like oh, my friend’s in classÂ today, I don’t need to go. And then I would still always do the homework and everything but I just fell behind.Â AMY WENZEL:
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[07:25] AMY WENZELOkay. Okay. So you fell behind and then you said it got the point where youÂ took a semester off from Illinois State. Correct?Â JOSH:Â Uh, not completely a semester. I just took a really
7 minutes 35 seconds JOSH
[07:35] JOSHlight load and then I took off from the fraternity. So my membership wasÂ in pause or on hold or something. And then I just never went backÂ to that. But I was always enrolled with the university.Â AMY WENZEL:Â Always enrolled in university. And you said since that time there’s been basically ups and downs.
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[07:50] AMY WENZELIs that right?Â JOSH:Â Yeah. One big down and hopefully one last big up.
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[07:55] JOSHBut I mean there were times where I would just lay in bed and not be able to go to class.Â Not because I wasn’t smart enough or I didn’t have the material or anything butÂ I was sure that if I did the homework I would get good grades, no doubt about it. But…Â AMY WENZEL:
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[08:10] AMY WENZELOkay, okay. Why don’t we fast forward and tell me about the past month then, in terms ofÂ some of the depression and anxiety. What’s been going on now?Â JOSH:Â The past month,
8 minutes 20 seconds JOSH
[08:20] JOSHI think if I look back next year, this’ll be the hardest couple, the hardest six monthsÂ in the past five years of my life. I’ve really just grabbed the bull by the horns, I think.Â And if I don’t succeed this semester it’s just gonna be game over for college for me. I’m graduating in May.Â AMY WENZEL:
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[08:35] AMY WENZELGood for you.Â JOSH:Â I have a full load of classes. And I’m trying to study for the
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[08:40] JOSHenrollment exam for the IRS.Â AMY WENZEL:Â Oh, terrific.Â JOSH:Â So I feel good about it.Â And I’ve been dieting and exercising. And I think that really helps with my mood and just being really positive.Â AMY WENZEL:
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[08:55] AMY WENZELSo you described it as the hardest six months but it sounds like hardest in terms ofÂ working hard and accomplishing. Okay.Â JOSH:Â But I mean there’s just,
9 minutes 5 seconds JOSH
[09:05] JOSHI had a quiz the other day I just didn’t do. You knowÂ so every once in a while I slip up like that and I have to really, for me it’s more aboutÂ getting into the habit of doing it.Â AMY WENZEL:Â Okay.Â JOSH:Â You’ve heard of the power of the habit, the book.Â AMY WENZEL:Â I sure
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[09:20] AMY WENZELhave. I sure have. Yeah, so this is interesting because both in your paperworkÂ as well as a couple things you said here suggest that the anxiety and depressionÂ are mainly now related to academic issues or academic stressers.Â JOSH:
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[09:35] JOSHAcademic stressers and just like succeeding and like what I feel I’m supposed to be doing in
2: Patterns of Thoughts, Feelings, and Behaviors
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[09:40] JOSHlife at this point.Â AMY WENZEL:Â Okay. Okay. So let’s take this specific example
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[09:45] AMY WENZELof the quiz that you didn’t do very well on. When was that?Â JOSH:Â That was
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[09:50] JOSHtwo weeks ago over the weekend. I didn’t do well on it, I just didn’t do it. I read the chapterÂ of the book. I couldn’t do it. BetweenÂ Friday, Saturday and Sunday night and I found a reason not to do it every single night untilÂ Monday morning. I’m just kicking myself cause I didn’t do it.Â AMY WENZEL:Â You didn’t do the reading? Or you didn’t take
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[10:10] AMY WENZELthe…Â JOSH:Â I did the reading. I did the work. I didn’t log onto blackboard our website and I didn’t
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[10:15] JOSHhit begin quiz.Â AMY WENZEL:Â I see.Â JOSH:Â And then go through the ten questions.Â AMY WENZEL:Â That’s what I was missing. It was an online quiz.Â JOSH:Â AndÂ it’s like three points for the class. I understand how every point in the class works. Four points I had to do to get an A.Â You can take the quiz three times without any penalty, write down the answer every time, you get an A on the quiz.Â I usually do that.Â AMY WENZEL:Â Okay.Â JOSH:Â I just,Â sometimes I just freeze up.Â AMY WENZEL:Â Okay. Let’s talk about hat freezing a little bit more. So when you’re
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[10:40] AMY WENZELover the weekend, you’ve read the book or you’ve read the chapter, you’re contemplating taking the quiz, tell me what runsÂ through your mind?Â JOSH:Â I just, I try to keep things from running through my mind. I try not to think about em.
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[10:50] JOSHI’ll get busy with something else.Â You know there’ll be, I’ll start looking at condos for my girlfriend on Craig’s List and spend an hour doing that.Â I’ll do laundry, I’ll clean everything. My room’ll be spotless.Â Everything, my car’ll be clean.Â AMY WENZEL:Â Lots of avoidance, huh?Â JOSH:Â Yeah, avoidance.Â I put everything else on the way that needs to be done. You got something that needs to be done, when I have something that needs to be doneÂ it’s probably the best time to ask me to do it. Cause I don’t wanna do what I have to do.Â AMY WENZEL:Â Okay. Okay. So if
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[11:20] AMY WENZELyou are forced to direct your attention to what you have to do, what would jump into yourÂ mind?Â JOSH:Â I mean, usually when I think of forced I think,
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[11:30] JOSH“Oh God, it’s the last minute to apply to graduate” forced. And then I just do it.Â Just bite the bullet and do it. It’s a really hard zone for me to get in. But certainlyÂ I can get into it.Â AMY WENZEL:Â Okay. So do you ever have any
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[11:45] AMY WENZELthoughts like, “I’m not gonna do well. I’m gonna fail.”Â JOSH:Â Yeah, certainly. Yeah.
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[11:50] JOSHDefinitely a fear of success type thing going on.Â You know.Â AMY WENZEL:Â Okay.Â JOSH:Â I switched majors twice in college.Â AMY WENZEL:Â Oh did you? Okay.
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[12:00] AMY WENZELOkay.Â JOSH:Â From accounting to finance and from finance to information systems.Â AMY WENZEL:Â Okay.Â JOSH:
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[12:05] JOSHSo I have all those credits and GSU put me into the interdisciplinaries program becauseÂ I had so many upper division credits but not one clear focus. SoÂ the last year in college I just spent focusing on accounting.Â AMY WENZEL:Â Okay. Do you think the jumping
12 minutes 20 seconds AMY WENZEL
[12:20] AMY WENZELfrom major to major, was that another indication of this avoidance pattern?Â JOSH:
12 minutes 25 seconds JOSH
[12:25] JOSHYeah. I don’t know what I’m gonna do when I graduate college.Â I’ve been, it’s the education, your entire life. IÂ didn’t feel like I was ready when I was an information systems major. And then I switched back to accounting.Â But…Â AMY WENZEL:Â Okay, okay. So let’s say you graduate and
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[12:45] AMY WENZELyou’re still a bit unsure here. Tell me about some of the things that you worry about.Â JOSH:Â Um,
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[12:50] JOSHright now in my life I’m trying to move up to the city, Chicago,Â to live with a girlfriend. And the girlfriend’s becoming a main motivator to do anything anymore causeÂ you can’t live at Mom and Dad’s house the rest of your life. Especially when they’re getting divorced.Â AMY WENZEL:
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[13:05] AMY WENZELRight.Â JOSH:Â So,Â AMY WENZEL:Â Hence looking for a condo.Â JOSH:Â Yeah. So I’m just trying to move,
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[13:10] JOSHtrying to get a job. I’ll take any job that you have to have a four year degree to take.Â So, the true requirement is to have a job for me.Â AMY WENZEL:Â Is it safe
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[13:20] AMY WENZELto say that you worry about things?Â JOSH:Â Oh yeah.Â AMY WENZEL:Â Okay. Tell me some more about yourÂ worries.Â JOSH:Â Money is always a big worrier. I live from paycheck to paycheck.
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[13:30] JOSHUm, buying books. I just got done buying books for the semester. The semester started like three weeks ago.Â AMY WENZEL:
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[13:35] AMY WENZELOkay.Â JOSH:Â So I kinda pay for things as they come.
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[13:40] JOSHAnd then this past month or two I felt really good about myself cause I’ve been taking care of things.Â And my credit report that I didn’t pay for, that I issued into normal.Â I paid off a thousand dollars for the past two months.Â Yeah. But now I don’t have much of a tax return left.Â AMY WENZEL:Â Okay.
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[14:00] AMY WENZELOkay.Â JOSH:Â I don’t know. I’m just trying to watch myself out there right now.Â AMY WENZEL:Â Okay. Okay.Â So you’re worrying about money. What else are you worrying about?Â JOSH:Â Moving.Â AMY WENZEL:Â Moving. Okay.Â JOSH:Â And do you
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[14:15] JOSHfundamentally do you focus on bad things that might happen, like things not working out?Â AMY WENZEL:
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[14:20] AMY WENZELFocus on like the worst case scenarios of what could happen. Like, “Oh my God Josh, if you don’t get back on the computer,Â type that email to that person and tell them this that you were supposed to tell emÂ this morning, you’re gonna be…”Â JOSH:
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[14:35] JOSHAnd when you focus on those worst case scenarios, what does that do to your mood?Â AMY WENZEL:
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[14:40] AMY WENZELI get into this mood sometimes and my girlfriend noticesÂ it, where it’s just like all of a sudden we’re in a hurry, I’m in a hurry causeÂ I’m thinking about something that I can’t get done where I’m at. And I don’t wanna tellÂ anybody else I didn’t do it. I have to go somewhere to get it done. But I just like,Â I have to rush through things. And then I lose attention to detail.Â JOSH:Â And so you lose attention to detail and you’re rushing.
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[15:05] JOSHWhat does it do to your anxiety level?Â AMY WENZEL:Â Um, if I get on
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[15:10] AMY WENZELthe track where I know I’m gonna get it done, my anxiety level goes down. But until there’s that moment ofÂ relief, it’s gonna be okay. Like,Â I couldn’t, the 50 dollars was dueÂ for the graduation fee on a Thursday and I got paid on a Friday. I didn’t know if I wasÂ gonna be able to have the gas to get here and then. Cause I’m only working part timeÂ right now. I didn’t know if I had the gas to get back and everything.Â JOSH:Â Okay.Â AMY WENZEL:Â And I was just like freaking out. AndÂ I went and I was just gonna pay for it and they’re like, “Oh, the graduation applicationÂ fee is due in March.” It was January, I think, late January.Â JOSH:Â Okay.Â AMY WENZEL:Â And then I felt good.Â JOSH:Â Okay. When you were freaking out,
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[15:55] JOSHwhat were some of the things that you said to yourself?Â AMY WENZEL:Â Oh like you’re not gonna graduate college.
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[16:00] AMY WENZELYour girlfriend’s gonna break up with you. You’re gonna be stuck living…Â JOSH:Â If I don’t graduate
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[16:05] JOSHfrom college this semester, I just can’t push it off for another semester. She graduated last year and I’m a year older than her.Â AMY WENZEL:
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[16:10] AMY WENZELOkay. Okay.Â JOSH:Â And she’s got a great job and everything.Â AMY WENZEL:
3: Applying the Cognitive Behavioral Model
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[16:15] AMY WENZELOkay. Okay. Can I share with you this modelÂ a little bit in light of what you’re saying here?Â JOSH:Â Certainly.Â AMY WENZEL:Â I’m gonna actually call your attention to this bottomÂ rectangle right here. In cognitive behavioral therapy, cognitive means how we think aboutÂ things or how we make meaning of things. I oftentimes find that when people struggle a bit with depressionÂ and anxiety, they tend to go to that worst case scenario, as you’re saying. Or they tend toÂ really focus on things that are excessively negative orÂ excessively unhelpful at the expense of some other pieces of information that might soften out the interpretationÂ a little bit. And I wonder if, and we call these automatic thoughts becauseÂ they come up just so quickly that we don’t even necessarily know that we’re thinking them. We just know that we’re anxious orÂ we just know that we’re upset. But a lot of time it can help usÂ to slow down, recognize what we’re thinking and then really take a good hard look at it to make sureÂ that we’re not forgetting about some other pieces that suggest that things aren’t quite soÂ catastrophic. I’m wondering what you think about that? I mean, do you think that’s relevant to you?Â JOSH:Â Certainly.
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[17:20] JOSHI mean an automatic thought, just the worst case scenario that I would have. Yeah,Â I mean. It pops in my head. Sometimes where I have a bigÂ failure or I think I have a big failure, I go, “Oh, stuck in this town for another year.”Â And so I’m unable to overcome it.Â AMY WENZEL:Â Okay.Â JOSH:Â But I mean, I see the rulesÂ and assumptions, I just assume I have to live in Joliet the rest of my life if I don’t graduate college.Â AMY WENZEL:Â Oh.
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[17:45] AMY WENZELThat’s so important there. Let’s talk a little bit more about the other pieces of the model.Â So these automatic thoughts, we kinda start at this level because they come up in particular situationsÂ and they’re the easiest types of thoughts or cognitions to identify.Â But there are all these layers that kinda of are underneath the automatic thoughts. And you’re absolutely rightÂ that people then hold these rules and assumptions like a number of patients I’ve worked with have had assumptionsÂ like, “I should get all As or else I’m a failure.” Or, “I should graduateÂ in a certain amount of time.” And it just puts so much pressure on them that then it’s very easyÂ to jump to these worst case scenarios when they’re faced with some sort of stresser.
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[18:25] AMY WENZELDoes that seem like that resonates with you?Â JOSH:Â Yeah. Certainly. I think it’s pretty in line with what happens to me.Â AMY WENZEL:Â Okay. Okay.Â JOSH:Â I don’t really understand. What’s the,
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[18:35] JOSHcan you tell me what the formative experience is?Â AMY WENZEL:Â Absolutely. Absolutely. So
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[18:40] AMY WENZELaccording to this model, oftentimes people have experiences,Â formative experiences just means a key experience from your life that really shaped the way that you view the world orÂ you approach life. And so oftentimes we have these experiences, perhaps with our parents,Â perhaps with our peers.Â JOSH:Â Adolescence.Â AMY WENZEL:Â Yeah. It could be adolescence. Although it doesn’tÂ always have to be limited to childhood like I actually wonder if the experience that you had at ISUÂ when you started to have all the stressers and have difficulties with the transition, mightÂ have been another formative experience that sort of stuck with you andÂ affects the way that you view the world. Is there any truth to that hypothesis?Â JOSH:Â Yeah. Definitely. I mean,
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[19:20] JOSHI have a different view towards university in general now.Â AMY WENZEL:Â Sure.Â JOSH:Â Towards anyÂ educational institution, I have a different view towards.Â AMY WENZEL:Â Okay.Â JOSH:Â At this point.Â AMY WENZEL:Â Exactly.
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[19:30] AMY WENZELSo that really kind of rocked your world a bit because up to that point youÂ had a very different outlook about school.Â JOSH:Â Yeah, I was much more optimistic.Â AMY WENZEL:Â Okay. Okay, okay. AndÂ oftentimes these formative experiences lead to what we call these core beliefs. And these are kind of,Â this is the most fundamental level of cognition. It’s a belief that you have about yourselfÂ or about the way the world works or other people that oftentimes just serves as a lens orÂ filter by which you view the world. And I wonderÂ with you, especially because of this experience that you had at ISU, if there’s a bitÂ of a fear of failure or this belief that you are a failure or that you won’t be successful.Â JOSH:
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[20:10] JOSHYeah, I mean I have a big fear of failure. But a lotÂ of it comes from just comparing myself, cause I was in league with a lot of really successful people.Â And going on Facebook now can be really anxietyÂ causing.Â AMY WENZEL:Â Facebook is dangerous for that.Â JOSH:Â You just go through, oh that’s a really nice house you bought.Â First job out of college. I wish I had stuck in school longer like you did orÂ done what you did while I was there.Â AMY WENZEL:Â Okay.Â JOSH:Â But I mean…Â AMY WENZEL:Â So it sounds like and
20 minutes 40 seconds AMY WENZEL
[20:40] AMY WENZELactually interestingly Facebook could almost be like another formative experience, not exactly like oneÂ thing that happened to you like what happened at ISU. But it’s like kind of a continual ambush,Â where you’re getting this message of it sounds like maybe what you’re making out of that that is thatÂ you’re not good enough or as good as other people.Â JOSH:Â Yeah. I mean that might be why I go
21 minutes 0 seconds JOSH
[21:00] JOSHto Governor State University. Because I wanted to be a bigger fish in a smaller
4: Discussing Avoidance
21 minutes 5 seconds JOSH
[21:05] JOSHpond.Â AMY WENZEL:Â Okay. Okay. Yeah, and what you’re actually identifying
21 minutes 10 seconds AMY WENZEL
[21:10] AMY WENZELthere is not even actually something that’s on our model but that’s still important. We call that a compensatoryÂ strategy. Where you’re doing something that compensates for a core belief that’s painfulÂ to face.Â JOSH:Â I have a lot of compensatory…Â AMY WENZEL:Â Yeah? What are some of the other compensatory strategies?Â JOSH:
21 minutes 25 seconds JOSH
[21:25] JOSHI mean just like I have to make habits to do things.Â Even going into classes now. Last semester,Â I show up to school like a half hour, 45 minutes ahead of time.Â AMY WENZEL:Â Okay, okay.Â JOSH:Â AndÂ I’ll sit in my car and I’ll eat. I’ll listen to the radio. Some podcast or something.Â I just have to relax myself on campus before IÂ go into class. I need to be in like that state of mind.Â AMY WENZEL:Â And what if you don’t relax yourself and
21 minutes 55 seconds AMY WENZEL
[21:55] AMY WENZELcenter yourself like that?Â JOSH:Â If I am running 20 minutes on the highway and I’m not gonna make it to class on time,
22 minutes 0 seconds JOSH
[22:00] JOSHwhy even go to class now?Â AMY WENZEL:Â Oh,
22 minutes 5 seconds AMY WENZEL
[22:05] AMY WENZELokay.Â JOSH:Â If you turn on the highway now you could be home in how long? What
22 minutes 10 seconds JOSH
[22:10] JOSHwould your mom say? What would your girlfriend say if she found out you’re missing class?Â AMY WENZEL:Â Sure,
22 minutes 15 seconds AMY WENZEL
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