Encouraging Optimism With Positive Expectations

This episode was pre recorded as part of a live continuing education webinar on demand. CEUs are still available for this presentation through all CEUs register@allceus.com counselortoolbox. Hey there everybody. I'd like to welcome you to today's presentation encouraging optimism based on positive expectations. And I, as you know, AM your host, Dr. Donnelly snipes in this presentation. Now, if you already looked at the PowerPoint, you know, it seems like it's a short one, but we've got a lot of stuff to cover. There are a lot of ways to try to teach optimism in groups. So we're going to talk about that. We're going to start by defining hope and optimism. Explore the connection between positive expectations and optimism. Identify blocks to optimism and steps to overcome those blocks. So just a little bit of research because you know, I like doing research. Patient coping and expectations about recovery predict the development of chronic post surgical pain after traumatic tibial fracture repair. Well, this is true with a lot of things. If people expect that they're going to go through a procedure and they're going to come out and they're going to be fixed and they're not going to have pain, then that's typically more often what happens. If they expect that you're going to come out and they're going to have chronic pain and they're going to have chronic problems, that's typically more often than not what can happen. So expectations have a lot to do with our perception of our quality of life, of recovery, of a lot of things. Patients who are optimistic about recovery following an injury will actually recover and return to work faster than patients who are less optimistic. So if we can encourage clients to be more optimistic, feel more empowered, feel more in charge of their recovery, then it's likely they'll be able to resume their normal life as a lot quicker than maybe otherwise. Positive patient expectations are associated with positive patient reported outcomes in surgery. Optimism is found to have a positive effect on personal recovery and mental health, even after a tornado outbreak. So even things that are not physical, if you have a positive outlook, then when bad things happen, the outlook and the person's recovery and reintegration restabilization tends to be a lot easier and a lot faster, faster with optimism. And optimism has been shown to significantly influence the course of some diseases, including cancer, HIV and coronary artery disease. And I couldn't find it when I was doing the research, but there was a study that was done way back when, golly, it was probably in the early 2000s that looked at the T cell count of patients that had HIV if they underwent a procedure where they would envision the T cells multiplying and doing what they were supposed to do in the body. And they found that people tended to show higher T cell count and maintain their T cell counts longer when they did this. So obviously it's just a correlation. There's no causation there. But there is a lot to be said for positive expectations and optimism. Why? Well, all these things are wonderful, but why? What does optimism do that helps us feel less pain, that helps us recover faster? Well, one of the things that optimism helps a lot of people do. And think about it, when you are pessimistic, or at least I will own it, when I am pessimistic, I don't sleep as well, I am stressed out, I toss and turn, my cortisol levels are higher. So between increased cortisol, which is your fight or flight chemical, which hinders physical recovery, it hinders immune system response. So when cortisol levels are up, recovery goes down. And when sleep is disturbed, then we tend to see a corresponding decrease in immunity and a corresponding decrease or slowing of recovery time. Another thing optimism can do, that it's kind of tangentially related, is reduced blood pressure. When people are pessimistic, they often tend to be more anxious and more stressed out. And there are improved health related behaviors. When we're optimistic, when we think, you know what, if I eat healthy, if I go on a walk, if I exercise, if I get enough sleep, I'm going to be happier, well, then guess what? People are probably going to engage in those behaviors if they believe, if they're motivated to do them, because they believe that those behaviors will have a positive effect on whatever ails them. And there are also studies that show that there's faster healing with optimistic people, people who see injuries or illnesses as temporary setbacks or annoyances. When I had surgery a couple years ago, I healed a lot faster than the doctor thought that I should heal, partly because I'm stubborn. And I kept saying, you know what? I don't need that much time to recover. And guess what? I didn't. My wound knitted back together, as she said, a lot faster than some other people. Now is that because of optimism or was that because I was a long distance runner and in really good shape going into it, so my blood was more oxygenated, who knows? But we do find that all of these things tend to be present in people with optimism. Thinking back to some of the research that Linehan did with Vulnerabilities. When people are sleep deprived, not only does that increase the levels of cortisol, because their body's trying to help them stay awake and the circadian rhythms get out of whack when cortisol levels are up, it reduces available serotonin. It has lots of corresponding effects on the body in terms of physiological and hormonal responses. So we know that if we help people increase their optimism, we're probably going to help them naturally increase their serotonin and naturally increase their GABA and not trigger as much of that fight or flight response. That's theoretical. Obviously we don't have a causation, but there's a pretty strong correlation there. So what are we talking about here? Well, hope and optimism kind of go hand in hand. And I read tons of stuff that I could find on hope and optimism. And the preeminent voices out there tend to kind of disagree on the difference between hope and optimism. But what I took from it. So my perspective that hope tends to be more of a passive emotion unrelated to the likeliness of the outcome. I can buy a lottery ticket and hope that I'm going to win the lottery. I have a 1 in bazillion chance of winning the lottery, but I can hope. Am I optimistic that I'm going to win the lottery? No, I'm really not, but I can have hope. Hope is based on the anticipation of positive future developments. So we can hope that things will turn out well. Optimism takes it a step further. It takes that hope and it does something with it. Optimism is confidence in attainment of the goal through a belief that the person will find a path to achieve that desired goal and will be motivated to walk that path. So not only do we have hope, which is this pot of gold at the end of the rainbow, we're hoping for that, but we're optimistic that we can figure out how to get there and we're going to have the dedication or motivation to get there. So how can you be optimistic, not just hopeful about winning the lottery, not saying that this is an effective way to do it, but if somebody went in and bought 10 million lottery tickets, likelihood of them winning would be a whole lot better. I'd be pretty optimistic that they'd get at least four or five in the numbers if they won the lottery. So that's optimistic. They know what they've. They've done things. Grad school, when you were going through undergrad, you could see your future goal of your career. You were hoping you'd make it there. And then when you went in to take your gre, you were hoping you did well on that one, because that's not an achievement test. But then when you started applying to grad schools, you were optimistic, hopefully, because you knew that you had studied hard, you had done the work, you had taken the tests and taken the steps. You had followed that path to get into graduate school. Job interviews can be the same way. You can be hopeful before you go into the to a job interview, and you can be optimistic before you go into a job interview if you've gone online and researched the company and you've rehearsed the most common interview questions and things. But for me at least, even if I've done all that going into an interview, I never know what questions they're going to pull out of their hat. So I usually walk out of the interview, and that's when I tend to hopefully be more optimistic, because I'm like, yeah, I nailed those questions. I did it well. And there is an interesting line between being optimistic and being hopeful that things will happen and denial. And. The line is that, I'm going to talk about that in a minute. The more control people perceive they have, the more optimistic and hopeful they can be. When somebody is diagnosed with cancer, for example, some people are immediately pessimistic. Other people tend to see options, tend to see treatments available, tend to see outcomes, tend to see people who've recovered, and they tend to be more optimistic. That, okay, you know, this is unfortunate. However, I see a path towards my goal, which is remission. And I believe that I can go through this path and achieve that goal. So. And when we start talking about optimism, I want clients to really think about how they perceive situations. So a lot of times I'll start this group with either. I usually do it with little. Those little plastic Easter eggs. And I will put over here in the side margin. You can see all these different things or challenges that people face. And the first one is life transitions. Depending on my group, there are going to be different life transitions. For example, if I'm working with adolescents, one of the life transitions may be leaving home or starting college. So I adjust that one based on the presenting issues of my clients that are in that particular group. But anyway, I put these different challenges on strips in eggs, and everybody picks up an egg when they walk in. And then we talk about the egg. I know we have to talk about everything because it's a meta concept, but the egg, in my mind, if you will, we talk about how it can represent renewal. It represents rebirthing. I don't know how to do a cocoon, or I'd probably do a cocoon. But what we're talking about is changing these ideas from something that is overwhelming and stressful to something that the person might be able to be optimistic about. So each person picks up an egg, has a different challenge in it, and I'm going to ask them how they perceive these things. To any challenge, an optimist reacts with fear, faith that they will reach desirable results, and continually take part in the activity, even if the process is long and difficult. And that is the thing. I remember when I was going through my dissertation, there were days. Oh, my gosh, there were days I was just. I didn't think I would ever finish. You know, my. My committee chair would give it back to me, and it would look like he had hemorrhaged on it. This is back in the day when we actually used pen and paper. So I would get frustrated sometimes, but I continued plugging away. It was a long process, but I could get there. Recovery is a long process, whether you're recovering from a broken leg or addiction or depression, whatever it is. So we need to help people recognize that this process is going to be a challenge. This process is like taking a drive down an unpaved road, if you will. The roads there, there's the path from where you are to where you want to be, but there are going to be some potholes along the way, you know, and you might have a downed tree that you got to get around, but that's okay. So the person with optimism goes, all right, well, when those challenges come, we'll handle them. An optimistic explanatory style is characterized by the use of attributions that are external, unstable, and specific causes of the particular event. The example that I give clients is when you're out and about somewhere and somebody trips and just wipes out. Do you think they are clumsy and they're always clumsy? Clumsy is something that's an internal characteristic. It's stable. You're either clumsy or you're not. And it's general. You know, you're clumsy all the time, everywhere. Or do they attribute it to external factors and think, oh, my gosh, there must have been a wet spot on the floor that the person slipped on? Well, that's an external cause of the person tripping. They slipped on the water. That's an unstable thing because the floor is not always wet. Usually it's dry, and it's specific. In this particular instance, this person had a clumsy response because they slipped on the water. So we want to try to help people make attributions that are more external, unstable and specific. Instead of owning everything and saying, I am stupid, I am bad, I am whatever. So at this point, after we talk about the tripping thing, I say, everybody, open your eggs. When you think about your challenge, whatever challenge is in their hand, what parts, if this were you, what parts would be in your control or due to internal factors? So, for example, we'll take social anxiety. What parts of social anxiety are internal to you? Your reactions to social situations, those are internal to you. Your thoughts, those are internal to you. What parts of social situations that provoke your anxiety are out of your control or due to external factors? Other people's reactions, particular situations, what parts of this situation are true all of the time? All of the time. When you're interacting with other people at this particular time, you get anxious. However, you know, there may be times when the person interacts, like on one on one that they're not anxious. And we want to say what's different about those times? But what we want people to do is focus on when they have social anxiety, what things outside of them are contributing to their anxiety. Not because they're not, because they've got poor social skills, not because of their anxiety, not because of anything with them, but because of this situation. Getting up in front of 20 people to give a lecture could be really anxiety provoking for just about anybody. But how often do you do that? You know, looking at specific situations instead of saying, in every situation, I feel this way, really getting down and honing in and going, what situations in particular do you feel this way? People using an optimistic strategy do not think too much about possible risks and imagine themselves in a situation when they're coping successfully. So I have people think, you know, we've gone through the challenges that they have in their eggs. But we move over here real quick because this overlaps with some of them. When you think about asking someone out on a date, what do you envision happening? And for a lot of people, they start thinking, well, that person might think I'm stupid, I might get rejected, I might accidentally spit on them when I'm talking to them. There are a lot of things that people could think. When you think of a job interview, what thoughts go through your mind about that job interview? When you're waiting on test results and all of us have waited on test results from the doctor or something before, or even just for our license or whatever, you have these feelings or these thoughts of, what if this didn't happen or I think I blew that test. Whatever your thoughts are, or if you find out that your spouse filed for divorce, some people find that out and they see their world come crashing down. So one of the things that I want them to do is start talking about when challenges come their way and start recognizing when challenges come their way when what is their drop back reaction? Do they automatically see the sky falling or do they automatically see an opportunity? So we talk about that for a while in group and then I say, okay, now if you're using an optimistic strategy and you're not thinking about the possible risks and you imagine yourself coping successfully, what would you be thinking? What would you be envisioning? What would it look like to you in your mind? When you think of asking someone out on a date, when you think of going through a job interview, what does that look like? You know, you walk in, you shake the person's hand, you sit down, they ask you questions, you're sharing a, you know, nice meaningful banter, whatever it is, I want them to paint me that picture of what that looks like. They're not thinking, what if I don't know the answer to the next question? They're not thinking, well, what if this person doesn't want to hire me for this reason? They're thinking about all the things that could go well. When you're waiting on test results again, if you were being optimistic, what would that look like? So for example, maybe you were waiting on test results from a biopsy. You could look at it and say, well, I went in as soon as I found the problem. We're getting the testing done, so we're probably catching it early. I've done all of these things to take care of my health. I'm overall strong, yada yada. You see where we're going with this? While they're waiting on the test results, instead of focusing on this is the worst thing in the world. Focusing on the things that they have done and where they're coping or resolving the situation successfully in some way. When they find, if they find out their spouse has filed for divorce, you know, that can feel like you've been punched in the gut. Part of them, you know, being so and so's spouse, that part is dying. Now if you want to think about it that way, it's been, it's been kind of crushed. So that part of them may need to be grieved. No doubt they've got work that they're going to have to do on that. However, they can stay focused on that and see everything else in their life crumbling. Or they can think, all right, this person filed for divorce. What's the next step I can do to help me have a happy life? Because what I want is a happy life. Maybe I want another relationship, I don't know. But whatever that person wants, you can't have back what you don't have anymore. Hope and optimism consists of three basic components. Goals. We need to know what we want. Will, determination, motivation, whatever you want to call it, you've got to have the get up and go to get up and get it, and a pathway to the goal. It doesn't matter how much determination you have. If there's a brick wall in your way, you're not going very far. So you need to know that there's a pathway. So in order to encourage clients to develop hope and optimism, we need to help them. And this is where the treatment plan comes in. We need to help them carve this pathway, clear this pathway for themselves so they can see how they're going to get from where they're at now to their final destination. Now, there's going to be a lot of steps in the process. Like I said, it's a unpaved road, and it's got potholes and a couple of trees down, but there is a path. And when they encounter some of those obstacles, they just need to figure out how to get over them. When people are negative and hopeless, they tend to notice the things that are not going the way they want. When they're positive, they often seize on the good things. When I was little, we used to go up to Laconia, New Hampshire, which is where my mom's family's from, and we would go up. There's Mount Washington maybe. I don't know, geography is not my strong suit. But we would always go up there and pan for gold. I don't know why. It was just something we did. And I always found it somewhat tedious. So I was usually in an irritable mood when I was up there because I was cold. And when you pan for gold, you take something that looks kind of like a colander or a sifter. You get a bunch of silt out of the river and you shake it, and you get the dirt to go through, and you look for the nuggets of gold. Well, a pessimistic person doesn't see any gold in there. An optimistic person notices those little nuggets that are in there, and they're not big nuggets, but they're nuggets. There's something to seize on. It's like, oh, I see this little sliver of gold. Maybe this is the right place to be. That person gets optimistic because they think they're on the right path. This person over here, they're just shaking everything back into the water. So encouraging clients when they're going through stuff, it's kind of like panning for gold. There's going to be some silt and some dirt and some gunk that they got to deal with, but there's also going to be some nuggets in there. If optimism is hope combined with perceived control and ability to achieve their goals, then then positive expectations can help people become more optimistic. I do want to point out that this only works for things that people have some degree of control over. If somebody is diagnosed, for example, with stage four cancer and there's no treatment for it, no amount of optimism is going to make that go away. They can have optimism about the final weeks or months of their life, but there are certain things that they may not be able to change. We do want to help people create positivity. And again, on this right hand side, I have some suggestions for topics that you can talk about because these are often appropriate to your groups. But I encourage people to start looking at events in terms of what they want instead of what they have lost or don't have. So if they're in a relationship and this can be a life transition and they break up, you know, the person wants to feel better. They don't want to be, you know, alone. They don't want to be isolated. They don't want to be abandoned. But what do they want? They want a friend. They want another relationship. Now, you can argue about whether it's healthy to jump right back into another one, but that's beside the point when we're talking about optimism. Maybe getting into a relationship right then is not going to be their best choice. But we need to say, what is it that you ultimately want to get back into another relationship? Okay, so we put that out here. That's our destination. So that's what they're. That's what they want. That's their goal. So what parts of it can they control? Well, they can either stay at home and cry and pursue the person that they just broke up with, or they can start trying to make new friends. They can look for new connections. What resources and capabilities do I have that you can use, that I can use? Well, if this person wants to make a friend, they're feeling lonely, they're feeling isolated. After this Breakup, probably they have other friends that they know, and their friends know people. So they may start going out on group outings, they may start putting themselves out there and socializing more that they can control. How have I or someone I know gotten through similar situations? So encourage them to make a list of these things. What is the likelihood that this path, that this journey is going to go well? What is the likelihood that I'm going to eventually find another relationship? Probably pretty dagum good. Why is it worth the effort? Why should I walk down this path? And some people after a breakup, they feel very defeated, they feel very helpless and hopeless. And it takes a while to get that motivation back to even want to engage in another relationship. And that's okay. Those are all things that you can work on. But it's important for the person to see that there is something else that they want. You know, even if they don't have this thing over here, that old relationship with that particular person, what they want is a healthy, happy relationship so they can start making a plan to get there. One of the things that you can do to help people create positivity are several things, depending on their creativity level, whether they're right brained or left brained, however you want to say it. You can have people write a story from where they're at right now to achieving their goal. What does that look like? They can have a heroine in there. It doesn't have to be a autobiographical thing. It can just be a narrative of what's gonna happen so they can see this playing out before them. If they're more logical, you can have them make a plan. Step one, step two, step three. If they're creative, they can make a collage about where they want to go and some of the things they need to do along the way. One of my favorite ones is a timeline. I have people on the whiteboard or we'll tape pieces of paper together so they can make a nice long timeline where they're at, where they're going, and then they mark all the important steps in between for what they need to do to get to where they want to achieve their goal. Then I have them put a sticker or a stamp or depending on the age of the client that I'm working with on each of the steps along the way that when they think about it, makes them feel anxious where they're going. I don't know if I can do that. Or that seems pretty overwhelming because some of the steps they're going to be easy peasy. Other steps are going to be a little bit more anxiety provoking. So then we can look at this timeline along the way and we can see where there are the potential down trees, those anxiety provoking situations and help them figure out how to deal with it. But then we can also see where there's periods of smooth sailing and they can rest in the notion that it's going to get easier. Another thing people can do to create positivity that is just tangentially related to any particular goal is daily positive journaling. Research has found that people who journal for 15 to 20 minutes a day about the positive things that happen that day tend to start having a more positive outlook about everything. So it's something worth considering. Create a positive self fulfilling prophecy. So reframe the situation using specific changeable attributions. Let's stay with the breakup. One that's common theme or issue that we deal with in sessions. What happened in this particular relationship? If the person says, I fail at every single relationship I am in, well, that is very internal, that's very stable, and that's very global. So let's look at this, reframe that situation. Why did this particular relationship fail? What parts were in your control? What parts did you had nothing to do with you. It was, you know, because it takes two to tango. Encourage the person to look at that situation. They can learn from that situation because they may have done things in that relationship that weren't healthy or weren't helpful, but it doesn't mean they have to do them again. So it's changeable, it's specific to that relationship. So we don't want to generalize what happened in the past five relationships and expect it's going to happen in the next five. Teach them how to set smart goals. Specific, measurable, achievable, realistic and time limited. You know, make those small goals along the way. So if somebody breaks up and they want to get into another relationship, okay, well, thinking that they're going to be in another relationship in two weeks, that's not realistic. So what are your first, what are the first goals that you want to make? And for some people, they need a period of readjustment and grieving and dealing with their stuff. So that's the first thing. So how long do you want to give yourself to go through the grieving process? And these aren't hard goals. If they need a little more time or they get finished a little sooner than they thought, great. You know, we just adjust the timeline. But encourage them to set goals so they can see those steps. Encourage Them to avoid rigid expectations for other people's behavior. You know, when we expect other people to behave a certain way, then we often end up disappointed. So in order to encourage positive expectations to believe that people are doing the best they can with the tools they have at any point in time, encourage people to have flexible expectations. And the key in that phrase or set of phrases, people are doing the best they can with the tools they have at any point in time. So Sally may have a lot of tools, and she may be doing really well most of the time, but then life throws her a really hard curveball and she is not behaving the way others would expect them to be. Does that mean she's disappointing other people? No. Well, they may get disappointed, but that's on them. Those people need to look at it and go, is Sally doing the best she can with the tools she has at this point in time? We don't want to have rigid expectations for the way things are going to turn out. You may have optimism that you're going into this job interview and you're going to get the job. Okay, that is one, but that's kind of rigid. You don't know if you're going to get that job. You may not get that job because for some reason you weren't a good fit for the team that you would be working with. So having expectations that things are going to turn out okay, I'm going to get a job, but I don't necessarily know which job I'm going to get. And avoid expectations for something extraordinary. And I know that sounds so depressing, but we don't want to set ourselves up to think that we live in Disney fantasy worlds. So when you meet the love of your life, you're probably not actually going to hear bells or see fireworks or whatever. It's just probably not going to happen that way. So if you don't expect something, you know, extraordinary, then you're probably going to be happy with the way it turns out. Because a lot of times we set ourselves up expecting this huge climax, and then we walk out of it and we're like, yeah, not so much. I do that with a lot of movies. I get all psyched because I see the trailers for it and I go to the movie and I'm expecting something extraordinary and not that way. Shore up your resources. In order to do this, you have you know where you're going. You reframe the situation using specific changeable attributions so you know that not every situation is going to turn out badly. And that future situations could turn out really well. Set smart goals. Now you've got to take up, take your resources. If you're going fishing, for example, you know you want to go out, you know you want to catch fish, you don't necessarily know what kind of fish you're going to get, but what you want to catch fish, you know what you need to take with you. You wouldn't go out without a fishing pole. So once you know what you want, then you've got to figure out what you need to get what you want. Encourage people to envision the positive repeatedly, daily, multiple times a day if they need to. I know before I go in for a job interview or anything like that, I envision myself successfully going through it the night before and sometimes days before, but definitely the night before that morning. And then probably right before I go into that interview, I get to wherever it is I sit in the car, I envision everything going well, and I'm like, alright, I got this. And I get up and I do it. The more we mentally rehearse, whether it's the perfect dive for somebody who's a diver or the perfect dismount for a gymnast, or the perfect job interview, the more we mentally rehearse it, the more likely we are to be able to follow that path. Act as if this is one of my favorite ones. I asked people, you know what, especially people who've been women who have been parents in the recent past. I say, those days that you never got out of your pajamas, how productive were you? How energetic did you feel? How, you know, happy were you on that particular day versus a day that you got up and got dressed and, you know, you were ready to take on the world. Some people can relate to that. I know that I've even seen a difference in the productivity of my staff on casual Fridays versus other days of the week when they're dressed up, when we dress up, when we dress up like we are expecting to be successful, then we tend to fill that role. If you're walking around and you're downtrodden and looking like you're miserable, then it's probably going to be harder to do things. If you have that optimistic attitude and you're like, alright, I got this one, then that's what's important. Think about a batter that is, you know, at home plate. I don't know much about baseball, but he swings and he misses the first one. The coach cheers him on. He goes, alright, that's fine. You got it. You got this next one. This is what we want our clients doing for themselves, they're not going to have a home run hit with every single swing. But we want them to encourage themselves, act as if every time they go up to that plate, act as if they're going to hit that home run. Encourage them to attribute failures and setbacks to a certain extent to external, unstable, and specific causes. And like Carl raised before, you don't always want to blame everyone and everything else for bad things that happen. But we do want to take into account the context and everything in the situation, not just what I did, and use the rule of expectations. People rise to the occasion. Even if you're just setting the expectation for yourself, if you expect yourself to succeed, then you're more likely going to succeed. If you expect your children to behave a certain way or to succeed, they're more likely to succeed because we rise to expectations. Looking at some of these things, let's go with relapse. You know, a lot of our clients come in, and maybe they've had short periods of recovery before from depression or addiction or whatever it is, and they're feeling negative now. Every time I go through recovery, they say I relapse. This is pointless. I am never going to be able to recover. Well, all right, so let's go back to step one and start creating some positivity. What's their goal? Their goal is not the absence of their problem as much as it is to have a happy, healthy life. So their goal is to have a happy, healthy life. What parts of that can they control? What resources and capabilities do they have that they can use? How have other people gotten through similar situations? What is the likelihood? And this one is where it gets a little dicey sometimes. What is the likelihood that this will go well? And if they go slim to none, then we want to start taking a look at that. What is the evidence for that? When you have done this in the past, have you done this exact same thing? You're making some changes now, so there's a chance that, you know the result will not be the same. They're in your office. They're really wanting recovery. They're really wanting a happy, healthy life. So we know they haven't given up completely. So we want to ask them, why are you here now? Why is this worth the effort? Why are you willing to do this hard work again and not necessarily ask why questions? Because that can feel antagonistic, but encourage them to look at all their motivations for trying again. We want to help them get hope and energy and enthusiasm and get that, okay, I got this sort of attitude. Help them reframe their past relapses using split specific changeable attributions. When you relapsed in the past, and again, depression, anxiety, whatever, when you have become symptomatic or relapsed in the past, tell me about that specific situation. And you know what changed because you had a period where you were feeling good and then you had a period where you were symptomatic again, so what changed? And that's those changeable attributions. If they say, well, I quit taking care of myself, quit eating healthy, I was working 16 hours a day at work, yada, yada, yada, well, that's something that changed, that's something that's changeable. And we recognize that in that person, when they start doing that, they're more likely to relapse. Encourage them to set smart goals so they know now that it's imperative henceforth and forevermore to not work 16 hour days, to set boundaries and only work so many hours a day or a week to eat healthfully, whatever it is they need to do, those are their smart goals for recovery. Those are things that are present, things that they're doing when they are not symptomatic that'll help them really hone in on it. When they start seeing that, okay, I'm going along just fine, I'm feeling great, and then I start doing some of these behaviors or failing to do some of these things, and then I relapse, they're going to start to see a connection between their behaviors and their relapses so they can set smart goals in order to make a individualized relapse prevention plan. Encourage them to avoid rigid expectations. With depression, for example, you are not going to be happy every single day of the year. It's just a fact of life. None of us is happy all the time. We have days where we're kind of blue and some days downright depressed because things happen. Life has a variety of emotions and that's okay. So encourage them to embrace the expectations that, yeah, I may have a bad day, I may have a day where I've got cravings, I may have a day where I'm depressed, but that doesn't mean I failed, that means I'm having a day. Encourage them to shore up their resources and envision the positive repeatedly. Not only doing what they need to do to achieve their goal, live that healthy lifestyle, whatever it is, but also envision handling the things that have led to their relapse before. Encourage Them to act as if, you know, continue doing the things they need to do to stay in recovery and attribute failures and setbacks to external unstable specific causes. So when they have a bad day, when they're having a day where they're feeling depressed, encourage them to look at what was it that they did or they are doing that either supporting their recovery or not, but also what other factors are in there. Maybe they look and they realize, you know what, I just realized that I started getting depressed and you know, it's almost time for the time to change again. And we're only having seven hours of daylight a day and I know I'm susceptible to seasonal affective disorder. Okay, well that's an external unstable specific cause that can be addressed. So encourage people to really look for factors like that so they don't feel like things just happen. Things happen, but generally there are precipitants. And encourage them to have the expectation that they can achieve their goal. Step three is eliminate the negative self fulfilling prophecy. Moderate unrealistic or negative expectations or moderate them. When people expect to be depressed, when people expect to relapse, when people expect things, then guess what, it's going to be more likely that they're going to do it. They're just setting themselves up, they're going, you know what, I know I'm going to relapse. So we want to help them look at the facts and probability that they're going to relapse or that something negative is going to happen. If they're waiting for those test results to come back, what is the probability that those results are going to come back in an unpleasant way? What's the probability? What are the facts? Okay, if it comes back negative or where they've got the problem, what are you going to do about it? Does that mean your world is over, your life is over? Those exaggeration or magnification type thoughts. So encourage them to moderate these unrealistic or negative expectations. Yeah, bad things are going to happen. However, how likely is it that they're going to happen? And when they do happen, does it mean your world is going to end? Or what options do you have? Examine thoughts and expectations based on prior learning because they've probably been through other situations before. Encourage people to learn from the past because, because it doesn't have to repeat itself. One of the things we say a lot in addiction recovery is if you do what you've always done, you're going to get what you've always got. If you do something and the same thing repeatedly and expect different results. That's the definition of insanity. However you want to say it, encouraging people to look at things, if they have a history of bad relationships and, you know, a lot of people do they have multiple bad relationships? Okay, does that mean every relationship is going to be bad? No, it doesn't have to be. But we need to look at each one of those relationships that failed or went badly and figure out what went badly and why. Learn from it so you can act differently, so you can choose different behaviors. And in new relationships, sporting events, you have a team that goes out there, and my team is kind of struggling this year, and they go out there and they just play miserably. Does that mean they're always going to play miserably? Does that mean they suck as a team? Not necessarily. You know, they're. The other team may have had an extremely amazing defense or something. So we want to encourage people to look at the specific situation. Why did you lose against this particular team on this particular day and look at all your losses and figure out, is there a weak point? Is there something that you need to work on, like you need a new quarterback? All of those things can add up. To help the person create the plan for how they're going to become a winning team next season, encourage them to remember that things can change if they have have had difficulty coping, they have anxiety or depression, they've had difficulty coping with life on life's terms in the past. It happens. You know, sometimes life just kind of pummels you for a while and it feels really bad. And people with the most amount of coping skills need to rely on other people. You know, life can knock anybody down. But does that mean that you have no ability to cope with stressful situations? No. You know, it means that maybe you need to learn some more coping skills, need to learn some more tools, need to have a better social support system. I don't know. I don't know what it looks like for that particular person. I have to say. Okay, you've struggled with coping in the past. Let's talk about why that is. And what do you think would help you cope more effectively in the future so you can deal with life on life's terms. And then let's make a plan. Some people, you know, need a variety of different tools. And step four, get support. I encourage people to get support because it's hard to be positive all the time. So being surrounded by positive people, encouraging people, cheerleaders, is really helpful. Other people are more adept at helping you find those hidden nuggets. So if you're panning for gold and you're just seeing a lot of sludge and you're getting frustrated, encourage somebody else to have you help you look and find those nuggets. Because even in the yuckiest sludge, you can probably find something that is maybe not a gold nugget, but maybe it's a really pretty rock. I used to find lots of really pretty rocks. But encourage other people to help you, because sometimes if you're getting into that mindset where you're just expecting to not have a happy outcome, a fresh pair of eyes can say, hey, look. Look down there. We used to do that all the time when we'd go out fishing. When I was little, I'd start getting frustrated. I was 8. I had the attention span of a gnat, so I'd start getting frustrated. And then my uncle or my father would see something out in the distance, and they'd be like, oh, look at the dolphin out there. Let's go that way and see whatever. But they were always able to help me find the hidden nuggets. In life, other people are great cheerleaders. Sometimes life is just unpleasant, and we need people at our back going, this is really hard, and I really wouldn't want to be in your shoes. I can only imagine how much it hurts right now. But I'm here for you, and you got this. I've got your back, and I can help you anytime you need. Other people can help you identify unrealistic or pessimistic thoughts, but you got to know what those thoughts are. I was talking to my daughter this morning, and she was talking about, you know, just help me make the anxiety go away. And I'm like, well, what are you anxious about? She goes, I don't know. Well, start keeping a thought log so we can start looking at some of the things that you're stressed out about. If you don't know what you're stressed out about, it's hard to address it with optimistic thoughts and then make a plan. There's an app on Android and iPhones called the CBT Thought Diary app. It's free. It's one of those apps that people can download that can help them track their thoughts throughout the day and encourage people to support themselves by being mindful and intentionally focusing on the positive. When they notice they're being negative, encourage them to stop, reframe the situation and look at what it is that they want and figure out a way to get it. So if they're in a job that they hate, they can focus on the fact that they hate their life, they hate their job, and they're going to get stuck in the hate. That doesn't tell me what you want. What do you want in a job? You know, and how can you go about getting it? You know, figuring out what you want in a job and trying to find places, employers that offer that kind of situation and then applying to those jobs. You know, you see how you make a plan. But if you focus on what you want instead of what you don't have or what you're unhappy about, then you can move forward. Otherwise, you tend to be stuck. Have clients identify how they can involve other people in their recovery process. So not everybody likes to share their thoughts and feelings. Not everybody. Some people want a cheerleader to call them every day and go, how you doing this morning? You got this. Some people don't want that much hand holding or whatever, that much cheering. So encourage people to figure out who they've got in their network. That is a good, positive person. I've told you guys before about my best friend in college. Her favorite word was fabulous. Everything was just fabulous and it was contagious. Whenever you were around her, you felt fabulous. She was positive about everything. And yeah, life did not go her way some of the time, but she had this knack for making lemonade, if you will. But. So I always remember that whenever I hear somebody say fabulous. But figuring out who in your world is positive and can be a good cheerleader and can be helpful at helping you find the hidden nuggets and how can you involve them in your process. Do you want to call them? Do you want to email them? Do you want to meet with them once a week for coffee? What is it that you want? So positive expectations inspire optimism. We need to help clients just change the way they see things. And in response to Andrea's question, how long does it take for most clients to alter these thought patterns? A while. It takes 30 days to break a habit, they say, and that would be 100% success for 30 days. Not having a negative thought for 30 days, that's not going to happen. That's one of those unrealistic, rigid expectations. So we want to encourage people to keep track of their positive thoughts, keep track of their mood. Generally, I find anywhere from three to six months and people start being significantly more optimistic. Now, there are some apps out there that for mental health, for depression, for anxiety, that indicate that if people use it for 30 days, they show significant improvements in their optimism and reductions in anxiety and depression. They didn't have any data to back it up, though. So I couldn't look at the studies and go, what does a significant improvement look like? I don't want to set clients up to be disappointed or for failure. And I also don't want them to think that as soon as they start doing this, they're just going to suddenly be this optimistic person. The first step is helping them see why it's important to shift their focus to optimism. How can it help them achieve that rich and meaningful life that they so desire? Whatever they define that as, how can optimism help them improve their relationships or have more energy or be healthier? Whatever it is that they want, however they define a rich and meaningful life. And that's where that optimism research comes in. So we can actually show them tangible research that says, you know what, your attitude, your optimism, your perspective plays a big part in how successful you can be at achieving some things, and these are the reasons why. So we encourage them to get motivated about becoming optimistic and then help them move through the process, and we'll go back and look at that in just a second. Hope is a feeling that things will work out, like buying a ticket for the lottery. Optimism is a cognitive belief that the path has been set, and if you follow that path, things are going to work out. You've done what you need to do, and it's just going to unravel from there. Or ravel, I guess. Helping people develop positive expectations means addressing negative expectations, encouraging them to envision positive outcomes, creating a realistic plan, and getting support. So let me go back real quick. I've still got a couple of minutes. So let's just say the goal, you know, they are pessimistic. The goal is to create optimism. So that's a reliable goal or a realistic goal. What parts of this can they control? Well, they can control their thoughts. However, they're not going to control them 100% of the time right away so they can learn to control their thoughts. What resources and capabilities do I have that I can use? This is where we give them apps where they can track their thoughts. We give them handouts of these steps so they can reframe it in a positive look. We can encourage them to take one challenge each day and apply these steps to that challenge so they can see it in a more positive light. So they start getting used to using the positivity framework. How have I or someone I know gotten through similar situations? You may not know anybody who's decided to become optimistic, but a reasonable question, what is the likelihood That I can start becoming optimistic. For most people there's probably a pretty good likelihood. So, you know, we want to judge their sense of efficacy here and do what we can to bolster their efficacy. And why is it worth the effort to start changing the way you view things? Instead of being pessimistic, being optimistic, create a positive, fulfilling prophecy about being positive. So encourage them to reframe any hurts and hiccups in terms of specific changeable attributions instead of negative ones. Encourage them when things don't go the way they want, to identify what their goal is to be happy, to be positive, and set smart goals for achieving that. So how can we become more positive? Well, start out each day with a positive affirmation. Then when things happen, use the steps of the positivity worksheet to reframe those ideas. You know, there are different things that you can use for your clients. Encourage them to avoid rigid expectations that they're going to be just obliviously positive for immediately. You know, they, it will take time to change that way of perceiving life and perceiving the world. And you know, with those rigid expectations, don't expect things are always going to go positively. There are going to be hiccups and there are going to be hurts in life. Encourage them to act as if they are that positive person. And I've done this before. Some days if I'm having a particularly snarky day or something, I, I will act as if I'm Stephanie, my best friend from college, and I'm like, okay, how would Stephanie react in this situation? And it makes a world of difference. Attribute failures and setbacks to external specific causes and use the rule of expectations. If you expect you're going to become more positive, then you're probably going to. Again, encourage them to keep logs, keep baselines of some sort so they can see themselves becoming progressively more positive. And I usually have them focus on how many positive thoughts they had during the day as opposed to how many negative thoughts because I don't want them focusing on the negative. Eliminate the negative self fulfilling prophecy to encourage them to, instead of saying, I can't do this, I can't be positive. Encourage them to envision themselves being positive and figuring out what is it they need to do in order to be positive. Sometimes that's getting a good night's sleep, sometimes it's aromatherapy, sometimes it's a mindset. What will it take for that person to be in a positive mental space? Because it's a whole lot easier to be optimistic and positive. If you're in a positive mental space, encourage them to get support to help them. You know, notice if they start getting a little negative for somebody to go up, you know, what's the opposite of that? So those are steps they take. Again, three to six months I think is a real realistic. Not that they have to be in therapy that whole time, but three to six months for them to really ingrain these new perceptive behaviors I think is relatively reasonable for most people. Are there any other questions? Okay, everybody, have an amazing weekend and happy 1st of November and I'll see you next week. If this podcast helps you help your clients or yourself, please support us by purchasing your ceus@allce.com or or getting your agency to sponsor an episode. 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