(this is raw unedited text transcribed directly from the audio)
Male: Look, I’m sorry I cut you off like that before. I’ve just never gone in for that psychological mumbo-jumbo. They show you a bunch of ink blots and ask you about your toilet habits. Why does everything we do shrink straight in the crotch?
Dr. Kenner: That’s from Frasier and that’s his dad and you know, when I went to school, we studied inkblots. We studied Freudian therapy. We studied behavioral therapy and you may not know what those are. But pretty much something else came on the scene and just took off. And that’s a new type of therapy. It’s actually not new anymore. It’s cognitive therapy. With me today is Dr. Jeff Riggenbach, a cognitive therapist in the state of Oklahoma, practicing at Laureate Psychiatric Clinic and Hospital. And he’s developed their cognitive therapy behavioral based borderline personality disorders treatment program, and he’s completed training with the Beck Institute of Cognitive Therapy. That’s the gold standard, and is certified with the Academy of Cognitive Therapy. He gives seminars, that’s where we met, on cognitive therapy and routinely is an adjunct professor. Welcome to the show, Jeff.
Dr. Riggenbach: Hi Ellen, thank you.
Dr. Kenner: Tell me, what is cognitive therapy?
Dr. Riggenbach: Sure. I mean, cognitive therapy is based on the idea that our thoughts influence our feelings, so in essence, when we learn to change the way we think, we can change the way we feel. We all have sort of been programmed, if you will, to think in certain ways, by people we were around, primarily early in life, but also later in life, and those of us that were taught to think in ways that don’t serve us well, that cognitive therapy helps reprogram the way that we think.
Dr. Kenner: I can remember growing up and being afraid to speak my mind. You could speak your mind on some things, but on other things, I just knew it was better to just shut up. So I trained myself over the years to hold in stuff. So what would cognitive therapy do for me?
Dr. Riggenbach: Well, Ellen, that is one of the messages that I think a lot of people have, that it’s not okay to share your feelings or it’s not okay to talk about certain topics or it’s more important how things look on the outside than how things really are, and so that’s kind of a message that a lot of people have internalized over the years. One of the things I think is important is recognizing that what serves people well in one context doesn’t always serve them well in another context. For instance, keeping our mouth shut in an environment in which we might be put down or belittled or maybe even hurt if we opened it was probably best in that environment, but that isn’t necessary once we get out of that environment. Actually, not only is it necessary, but sometimes it can be harmful not to be able to express feelings when we’re talking about in relationships or in work conflicts or those sorts of things. I think that’s one of the first steps, is recognizing that that old behavior that was learned as a result of a way we were taught to think isn’t necessary and not only is it not necessary anymore, sometimes it’s not helpful. I think that’s the first step.
Dr. Kenner: And in one sense, it’s not that we’re taught, it’s that we as kids come up with different coping strategies. It can happen in very good families that you don’t know how to express yourself and not every mother and dad, very well-meaning parents, many of them don’t have the parenting skills to be able to encourage their kids to speak their minds but to do it properly.
Dr. Riggenbach: You’re right about that. As children, we take things differently. There may be a number of different factors, but a lot of messages can be received, just because in terms of communication, because we receive a message doesn’t mean that’s the message that our parents or whoever the sender of the message was intending to send. You’re absolutely right about that. Some people come out of families that are really pretty loving families and really caring and want the best for them, but still develop certain ways of coping.
Dr. Kenner: And yet still feel repressed. Now, obviously I’m not repressed anymore, and one of the things that helped me enormously, guess what it is?
Dr. Riggenbach: What is that?
Dr. Kenner: Cognitive therapy.
Dr. Riggenbach: Wow, I did not know that.
Dr. Kenner: It’s not that I went to cognitive therapy, but one of the benefits of becoming a therapist is what? What do we learn? We learn wonderful skills.
Dr. Riggenbach: You really do learn a lot of skills, in terms of managing your own life. That’s one of the things I really like about cognitive therapy. Just really practical skills that anybody can use to manage our lives from day to day. Certainly it’s helpful for people with more serious mental conditions, but the skills from cognitive therapy can be helpful for every single one of us managing our day-to-day lives.
Dr. Kenner: Let’s say I’m planning a vacation with my kids and I’m really anxious because there’s so much to do and I’m trying to please my husband, trying to make sure everybody’s needs are met. How could I use cognitive therapy?
Dr. Riggenbach: Well, actually, as you mention that, I’m thinking about a lady I worked with not too long ago who had that exact scenario. Maybe not the vacation, but just really feeling like she had to please her parents – her mother specifically – and to please her husband and please her children. One of the things she came to learn was that by not saying “no” to her children, which was making things easier for her in the moment, and she thought was really doing them a favor, she was able to recognize was not doing them any favors, or at least wasn’t going to in the long run. We had her in a group situation where she was able to hear from other people who were raised in a way that their parents didn’t set any limits or didn’t tell them no and hear from other parents in the group. And hear how their experiences really impacted negatively. Although at that point she didn’t have a good enough self esteem to really care how it affected her, she was able to see how not saying no to them actually was hurting them. So that was a bigger motivator for her.
Dr. Kenner: She was initially feeling real anxious or bummed out. How do you get to the thought level with her as a cognitive therapist?
Dr. Riggenbach: Well, you want to start with, there are a couple of ways you can do it. A lot of times if she comes in presenting anxious, which this lady did, and actually her initial complaint was not being able to get out in public and not being able to go around people and those kind of things. I would want to kind of feel her out and see exactly what her fear was about going out in public, because people have different reasons for not wanting to do that. Some people are afraid they’re going to contract a physical disease. Some people are afraid they’re going to get hurt or be mugged or something like that and some people are concerned that somebody might see them with their hair not done and are afraid of what other people would think of them. The first thing I would want to do is find out exactly what her reasons were for not wanting to do the things she was afraid of. Identify some of the specific thoughts and go from there with her.
Dr. Kenner: So you really want to get to the thought level. One of the keys, with cognitive therapy, you don’t just want to let people talk and talk and talk. You want them to identify what are the thoughts underlying your feelings? If you’re anxious, what are your anxiety-provoking thoughts? What are the thoughts that are making you feel depressed? And so you always want to get to the level of the thoughts, correct?
Dr. Riggenbach: That’s right.
Dr. Kenner: And then you want to see if the thoughts are accurate, reality-based or not.
Dr. Riggenbach: That’s right, and first of all, a lot of people, Ellen, have a difficult time really recognizing what is the thought verses what is the feeling.
Dr. Kenner: That’s one of the things – I know we’re right at the end of time. I know there’s a wonderful book Mind Over Mood that helps people see the difference between thoughts and feelings, am I right about that Jeff?
Dr. Riggenbach: That is an excellent book. It’s a good one to go to.
Dr. Kenner: And thank you so much for joining us today. I look forward to talking with you again soon.
Dr. Riggenbach: Thanks a lot Ellen.
Dr. Kenner: I have a review of that book on my website, DrKenner.com. I’ve got other books I recommend and articles you can read and I even have some courses I’ve given over the years that you could get. One is on romance and I wrote that with Dr. Ed Locke, and you can get that course at DrKenner.com.
I’m Dr. Ellen Kenner. The show is The Rational Basis of Happiness.