cognitive restructuring: reframing 9.pdfconsumed by their own negative thinking styles, which...
TRANSCRIPT
Image © Keith Brofsky/Photodisc/Getty Images.
Cognitive Restructuring:
ReframingEverything can be taken away from man but one
thing—the last human freedom, to choose one’s
attitude in any given set of circumstances.—Viktor Frankl
A bounced check. The roommate from hell.
A flat tire. Alcoholic parents. Stressors come
in all shapes, sizes, and degrees of intensity.
Scholars concur that it is not the circum-
stance that is stressful, but the perception or interpretation
of the circumstance. We now know that if the perception
is negative, it can become both a mental and physical li-
ability. Whatever the event, perceptions can become
distorted and magnified entirely out of proportion to
their seriousness. This is referred to as cognitive distor-
tion (mole hills into mountains), and it turns everyday
problems into gigantic monsters. Attempts have been
made to deal with the “stress monster” from all angles,
including decreasing or manipulating sensory informa-
tion and teaching people to control the stress response
by employing various relaxation techniques. Perhaps
the coping skill most advocated—which goes right to
the heart of the matter but is initially very difficult to
employ—is favorably alter ing the stressful perception
of the circumstance that has precipitated feelings of
anger and/or fear. This alteration in perception is made
through changes in cognition. Cognition is the mental
process that includes an assortment of thinking and rea-
soning skills. Across the country, this coping technique
goes by several names: cognitive restructuring, cognitive
Cognitive distortion: Distorting a situation beyond how bad it actually is.Quotation reproduced from Man’s Search for Meaning by Viktor E. Frankl. Coypright © 1959, 1962, 1984,
1992 by Viktor E. Frankl. Reprinted by permission of Beacon Press, Boston and the Viktor Frankl Institute.
CHAPTER 9
Chapter 9 Cognitive Restructuring: Reframing 215
reappraisal, cognitive relabeling, cognitive reframing,
cognitive therapy, and attitude adjustment. Despite the
variations, they all suggest the same approach: to favor-
ably alter the current mind frame to a less threatening
perception, from a negative, self-defeating attitude to a
positive one, which may then allow the initiation of the
steps toward a peaceful resolution.
The seeds of cognitive therapy took root in 1962 with the
work of Albert Ellis in what he referred to as rational
emotive behavior therapy (REBT). The premise of El-
lis’s work was that stress-related behaviors are initiated
by perceptions and that these self-defeating perceptions
can be changed. He explained that all stimuli sent to
the brain go through a process of interpretation. When
enough stimulation is interpreted as threatening, it be-
comes a critical mass of negative thought. Ellis was of the
opinion that once a critical mass of perceived stress arises,
it dims the ability to think rationally. As a result, a self-
defeating attitude becomes reinforced day after day, year
after year, through internal dialogue that is scripted by the
tone of these irra tional thought processes. Ellis became
convinced that people could be educated and trained to
favorably alter negative or stress-related perceptions (ir-
rational thoughts) into positive attitudes, which in turn
would decrease the intensity of perceived stress. In a 2008
news briefing, author J.K. Rowling of the Harry Potter
series shared publicly her experience with depression and
thoughts of suicide, and she credited the use of REBT as
what pulled her though her darkest hour. The term cogni-
tive restructuring was coined by Meichenbaum in 1975 to
describe a coping technique for patients diagnosed with
stress-related disorders. This coping style aimed to modify
internal self-dialogue by tuning into the conversation
within the mind. The practice of cognitive restructuring
was an important step in what Meichenbaum referred to
as stress inoculation, a process to build up positive thoughts
when negatively perceived events are encountered. Work
by Bandura in 1977 and Beck in 1976 also supported the
concept of cognitive change of perceptions as a means to
effectively deal with stress. To understand how stimuli are
interpreted and how interpreted thoughts are structured
from stimuli, let us take a closer look at how the human
thought process works.
■ A Thinking-Process Model
The human mind is an extremely complex phenomenon,
and one that we are just beginning to comprehend. Schol-
ars in the discipline of cognitive science have created a
theory, the information-processing model, to attempt
to explain exactly how the mind processes information ( FIG. 9.1 ). This theory suggests that sensory input
(e.g., a flashing blue light in your rearview mirror), sen-
sory manipulation (e.g., danger, speeding vio lation, slow
down, court hearing), and cognitive/behavioral output
(e.g., foot on the brake, pull over to the side of the road,
pray), as well as a feedback system to correct or refine
this mechanism (e.g., several officers going to the scene
of an accident, calm down), are synthesized to produce
a linear progression of mental processes. Each cognitive
deciphering process begins with an interpretation of the
stimulus that comes into any of the five (possibly six)
senses to determine its threat potential. In simple terms,
stimuli can be interpreted as either threats or nonthreats.
Resulting attitudes can be labeled in one of three ways:
(1) defensive (negative), (2) neutral (innocuous), or (3)
offensive (positive). Fragments of information, as well
as memories of previous similar experiences, are then
Rational emotive behavior therapy (REBT):
Developed by Albert Ellis as a means to help people cope with anxiety by changing the perceptions associated with the stressor.
Cognitive restructuring: A coping technique; substi-tuting negative, self-defeating thoughts with posi-tive, affirming thoughts that change perceptions of stressors from threatening to nonthreatening.
Information-processing model: A model that reveals how we potentially perceive sensory information, for better or worse.
FIGURE 9.1 The information-processing model of human thought.
Phase 1: Input(sight, sound, etc.)
Phase 3: Output(action, behavior)
Consciousappraisal ofstimuli
Phase 2: Processing Input(a) Conscious interpretation(b) Reasoning(c) Analyzing(d) Memory
216 Part 3 Coping Strategies
manipulated in a process that results in the accessing and
utilization of either left- (analytical) or right- (receptive)
brain cognitive functions, or a combination of both. In the
final outcome, perceptions and attitudes are by-products
of the interpretation of all sensory information. It is
both the manipulation of stimuli and the subsequent
interpretation process that are targeted in cognitive
restructuring to convert negative thoughts into neutral
or positive ones.
The purpose of cognitive restructuring is to widen one’s
conscious perspective and thus allow room for a change in
perception. The ability to expand perception is not merely
a poetic expression. Research by optometrist Jacob Liber-
man (1991) shows that an individual’s perceptual field of
vision actually constricts (myopia) under stress. Thus, one
literally sees less than the whole picture. Data analysis by
Anderson and Williams (1989) corroborates this evidence,
showing a causal relationship between perceived stress and
loss of peripheral field of vision. As Liberman points out,
stress forces one to see through a small hole rather than
view the entire field of vision or whole picture.
Unconsciously, many people use a nonproductive cop-
ing technique called rationalization that they think is
one and the same as cognitive restructuring. Cognitive
restructuring should not be confused with this defense
mechanism. Rationalization is making excuses, blam-
ing, and shifting responsibility away from oneself
toward someone or something else. Freud referred to
this as denial of reality. Cognitive restructuring, on the
other hand, involves assuming responsibility, facing
the reality of a situation, and taking the offensive to
resolve the issues causing stress. Creating and adopt-
ing a positive mind frame take some work. People
often find it simpler to avoid this responsibility and be
consumed by their own negative thinking styles, which
produce a preponderance of toxic thoughts.
■ Two Minds Are Better Than One
A documentary video called The Secret made international
headlines on the Oprah show and Larry King Live. Using
the Power of Attraction as its premise, several popular self-
help gurus spoke to the nature of achieving ultimate goals
of wealth and relationships merely by thinking positive
about these ideals. Countless examples were reenacted to
illustrate the abundance of the universe and the power of
intention. If they could do it, surely you could, too! The
problem is . . . it’s not this simple.
What the makers of the video failed to include (although
this may be revealed in subsequent sequels) is the power
of ego-driven thoughts from the subconscious mind
(a portion of the unconscious mind). So much of our
behavior (some experts think all of it) is directed by our
unconscious minds. Perhaps this concept is best illus-
trated by the famous actor Buster Keaton (and imitated
by Johnny Depp in the movie Benny and Joon) who tries
in vain to pick up his hat but repeatedly seems to kick
it out of his reach before he can grab it ( FIG. 9.2 ). If
the conscious mind and the unconscious mind are not
acting together, all the intentions and reframing in the
world aren’t going to help. In the field of psychology
this is known as the “unconscious resistance,” a self-
sabotaging effect that undermines the conscious mind’s best
efforts to make (positive) things happen. It is the foundation
of the negative self-fulfilling prophecy. Coaches see this
all the time with promising athletes. Physicians see this
in many of their patients too, specifically with patients
who say they want to be healed, yet have too much of
their identity wrapped up in the disease to leave it behind.
Here is another common example: Consciously, you want
to find that perfect person to go out with (or marry) and
you set your intention. Consciously, you believe you are
FIGURE 9.2 Silent film actor Buster Keaton was famous for his “kick the hat” routine, in which he would accidentally drop his hat and try to pick it up with his hand, only to repeatedly kick it out of reach before he could grab it. This routine is the perfect metaphor for how the conscious mind and one’s sub-sequent behavior (the hand) are greatly influenced by the unconscious mind (the foot kicking the hat). To change behavior, one has to unite the powers of both the conscious and unconscious minds.
© AP Photos.
Chapter 9 Cognitive Restructuring: Reframing 217
attracting your soul mate. But nothing happens. Perhaps
the reason why is because unconsciously you like your
carefree lifestyle and really don’t want to change. Perhaps
unconsciously, you still believe that you are not worthy
of a quality relationship. Regardless of the reason, some
belief system (usually an ego, fear-based one) hidden in
the depths of the unconscious mind is holding on to old
ways, thus negating the law of attraction to its highest
potential. This is the real secret: The unconscious mind
governs 80 to 90 percent of human behavior (Lipton, 2009;
Mlodinow, 2012).
Experts suggest that these old beliefs and perceptions are
learned and adopted early in life (ages 2–6) when the child’s
brain, like a sponge, soaks up sensory stimuli from the
child’s environment (e.g., parents, teachers, siblings). As
the child matures into adulthood, behavior is directed by
these ingrained, subconscious thought patterns and beliefs.
Until they are erased and replaced with new beliefs and
perceptions, not much will change.
To use an apt metaphor, the mind is like a radio playing
music from two stations (the conscious and the unconscious),
but the station you want to hear is being drowned out by
the one you don’t want to hear. In the case of the radio,
fine-tuning is in order. In the case of the mind, it is coming
to terms with old, fear-based thought patterns that tend to
hold us back from reaching our highest potential. If you
have doubts as to the power of the unconscious mind’s
influence, listen to the choice of your words spoken. More
than just Freudian slips, our choice of words often reveals
the ego’s hidden agenda.
Experts in the field of psychology suggest that the secret to
harnessing the strength of your thoughts is to combine the
powers of the conscious and subconscious mind to achieve
one’s goals and aspirations (Taylor, 2013; Mlodinow, 2012;
Murphy, 2008; Hari, 2005). Bruce Lipton speaks of this
with regard to the health and healing process in which
we need to erase the subconscious messages and rerecord
new thoughts to help navigate the intended direction of
our lives. Some people erase and rewrite these messages
through hypnosis. Others do reprogram themselves by
listening to subliminal CDs. Consciously, it can be done
through neurolinguistic programming (NLP). Still oth-
ers do it in a relaxed state through meditation and guided
mental imagery or hypnotherapy. So, here is a question
for you: What goals and aspirations do you have that are
sabotaged by early childhood programming (e.g., trust is-
sues, self-esteem issues, confidence, perceptions of leisure,
money, or relationships)? How can you reprogram new
(positive) thoughts, beliefs, and perceptions of yourself
that can steer you in the direction and to the destination
you wish to go? When you can answer these questions
you have really discovered “the secret.”
■ Toxic Thoughts
Negative perceptions are often the result of low self-
esteem. They also perpetuate it by suppressing or
obliterating feelings of self-worth and self-acceptance.
It has been suggested (Canfield, 1988; Ingerman, 2007)
that toxic thoughts originate from repeated exposure to
feelings of shame and guilt in early childhood. Canfield
cites a study conducted at the University of Iowa where
parent–child interactions were observed over a period
of several days. Results revealed that, on average, there
were 400 negative comments for every positive one spo-
ken to the child. It was concluded that negative thoughts
are actually a conditioned (learned) response that is then
carried into adulthood. Catastrophic thoughts are also
reinforced in the messages we receive from the headlines—
rarely does a human interest story beat a cataclysmic event
on the six o’clock news. Disasters, world problems, and
crimes permeate the news, which tends to condition our
thinking toward the negative side of things. Many coun-
selors, therapists, and psychologists suggest that negative
thinking has an addictive quality to it.
The term toxic thoughts was coined in the early 1980s
by several psychologists to educate their clients about the
dangers of negative thinking. Pessimism, a personality
trait heavily grounded in negativism, promotes toxic
thoughts. To demonstrate just how destructive they could
be, Dr. Leslie Kaymen conducted a study at the University
of Pennsylvania in 1989 to determine the phy siological
responses to stress between individuals who identified
themselves (through a psychological survey) as either
optimists or pessimists. All subjects were exposed to
minute doses of pathogens (tetanus, mumps, and yeast),
which, when placed on the skin, would indicate their
stress-tolerance levels. Subjects were then divided by
attitude into two groups, and both groups were given
an impossible task to complete in a brief time period.
While the pessimists quickly gave up, the optimists con-
tinued until the last possible moment. Days later, the PNI
response (skin rashes) of the pessimists was significantly
greater than that of the optimists. These results revealed
Toxic thoughts: Repeated negative thought process-ing that tends to pollute our view of our lives and ourselves.
218 Part 3 Coping Strategies
that an optimistic attitude was associated with sound
physical health, whereas a negative attitude perpetuated
the mental and physical stress response. In short, negative
thoughts can have a toxic effect on the body. Kaymen’s data
analysis confirms the hypothesis that negative thinking
can suppress the immune system.
In an updated version of Kaymen’s work, Andrew Steptoe
and colleagues (2008) designed a study with nearly 3,000
subjects to examine the biological links of positive thoughts
(mood). Results revealed that both men and women who
reported experiencing a happy mood had lower cortisol
levels, suggesting that happiness and optimism reduce
biological vulnerability. Moreover, female subjects indicated
significant decreased amounts of two proteins (C-reactive
protein and interleukin 6) that are associated with inflamma-
tion, a factor linked with heart disease and cancer. Steptoe
concluded that mood states are not merely hereditary, but
depend on social relationships and life purpose.
Dr. Lissa Rankin is a physician who has studied the ef-
fect that positive and negative thoughts have on health.
In her book, Mind over Medicine, she cites several studies
including one that investigated the early deaths of Chinese
Stress with a Human FaceA tribute to Allison Fisher: In the spring of 1991, I had a remarkable student named Allison Fisher. Allison was bright, energetic, and beaming with success. At the mid-point of each semester, I invite my students to do an exercise called “Confrontation of a Stressor.” I believe that the concepts of stress management remain only concepts if they are not practiced outside the classroom. In other words, to know and not to do is not to know. In this exercise, students are asked to pick one of their top three stressors and are given two weeks to resolve it—with the condition that they must enter the classroom with no bruises or broken bones. Although students are asked to write up this assignment, on the day it’s due we all sit in a circle with the lights down low and, one by one, under an agreement of confidentiality, we share our stories. This particular semester Allison went first.
“My stressor is breast cancer; it runs in the family,” she explained. “My mother has had it—my aunt and my grand mother, too. For many years I have been scared of breast cancer, because I know I am at risk. Upon hearing this assignment, I decided it was time to go for a mam-mogram. I was extremely nervous, but last week I made an appointment with my physician.”
The class was silent, all eyes fixed on Allison. With an air of confidence, she concluded her story with a smile: “I am happy to say that the test was negative!”
As a graduating senior with a major in broadcast journal-ism, Allison was looking forward to a promising broadcast-ing career. Less than a month after her graduation, she found herself working for a PBS affiliate. Within a year’s time, she took a job with Voice of America and then moved to Los Angeles to start a highly coveted job as an anchor/ reporter for Channel One, a cable program for high school youth. Several years later our paths would cross again,
when I found myself in Los Angeles for a book signing. We agreed to meet for lunch the next day. At that time, Allison confided in me that she was a cancer survivor.
To be a cancer survivor means you confront death face to face. You challenge it with a mindset rather than run from it with a defeatist attitude. Being a survivor means you adopt an attitude of realistic optimism. You acknowl-edge the problems at hand, but you focus on the positive. You live life in the present moment rather than reliving the past or worrying about what the future may hold. You break through the fear of dying, the fear of the unknown, and the fear of isolation, and you come through on the other side as a victor, not a victim—what Joseph Camp-bell called the hero of the hero’s journey.
“I had my first mastectomy over a year ago, my second one several months ago. The bad news is that the cancer is back and this time it has spread to my lungs. I’m okay, though,” Allison said confidently. Then Allison shared with me theories and concepts that I had taught her as a student—but now she was teaching me insights and wisdom known only from the perspective of a survivor.
“It’s all about attitude. I’m not sure how much time I have to live now, but I don’t have time for toxic thoughts, or the fear of what might happen. I chose to look at the bright side of life, because I discovered long ago that that’s all that really matters. I don’t know if I will be cured of my cancer, but I can tell you right now, I am healed of my disease, because I am at peace, and there is no greater feeling than this.”
Allison Fisher crossed the threshold of heaven on March 9, 1998 (www.allisonfisherfund.org).
Courtesy of Allison E. Fisher Mem
orial Fund, Inc./Pat and Ron Fisher.
Chapter 9 Cognitive Restructuring: Reframing 219
Americans who considered themselves ill-fated by being
born under less than auspicious astrological signs. The
results revealed that the more closely they believed in
the power of astrology, the earlier they died—deaths
that could not be explained by genetic factors, lifestyle
choices, lifestyle behaviors, or any other variables. Stated
simply, the negative thoughts they associated with their
fate impacted their health. Rankin states that disease is
not just a consequence of our genetic make-up, patho-
gens, or even bad luck. For better or worse, our health
is greatly influenced by our mindset (attitude). Negative
thoughts can compromise one’s level of well-being. Bar-
bara Frederickson agrees. As one of the leaders in the
positive psychology movement, Frederickson coined the
term “positivity” to express the power of optimism, as
expressed through love. “The new science illuminates for
the first time how love, and its absences, fundamentally
alters the biochemicals in which your body is steeped”
(Frederickson, 2013).
What is your PQ? PQ stands for Positive Intelligence, a term
created by Stanford University lecturer, author, and CEO
of one of the largest coach training programs in the world,
Shirzad Chamine. The premise of Positive Intelligence is to
reclaim the power of your mind by disarming the saboteur
(the voice of the ego that offers a steady stream of nega-
tive thoughts). Chamine states that the reason why only
20 percent of people reach their true potential is because the
mind is held hostage by negative thinking. Positive Intel-
ligence is a program to learn to reframe one’s thoughts and
harness one’s highest potential.
Is it really possible to change the programming in our
minds to break the habit of negative thinking? Accord-
ing to Richard Bandler and John Grinder (Andreas and
Faulkven, 1994), the answer is a definitive yes! Years ago,
Bandler, a psychologist, and Grinder, a linguist, combined
their efforts to create and teach the theory and applica-
tion of changing our mental language. They called it
neurolinguistic programming (NLP). The premise of
NLP is based on the concept of uncovering hidden gram-
mar woven in the unconscious and conscious thoughts of
our vernacular, systematically removing these expressions
as we think or speak, and learning to develop a language
of affirmative thoughts to positively change the direction
of our lives. NLP is an empowering skill to reprogram
the software of human linguistics so that our human ener-
gies can be focused in the direction of our highest human
potential or human excellence. Part sel ective awareness,
part self-hypnosis, the dynamics of NLP work to eliminate
the self-defeating thoughts that inhibit our energies and
keep us from reaching our goals. Over the years, NLP
has proven quite successful and is used by athletes, actors,
executives, business associates, lawyers, and professionals
from all walks of life. By encouraging reprogramming
and eliminating from daily vernacular words, phrases, and
thoughts that reinforce stress-prone behaviors, NLP helps
one to unlearn old thoughts and learn a new approach
toward optimal excellence. NLP Comprehensive, based
in Boulder, Colorado, offers seminars and workshops in the
dyna mics of NLP. Understanding that one cannot change
behaviors quickly as a result of a one- or two-day workshop,
the NLP training coaches participants through a 21-day
Achievement Program to help decondition and reprogram
the human thought process.
Far more than lauding creative and optimistic thinking
styles, Western culture rewards and praises critical think-
ing, the ability to judge and analyze situations, breaking
them down into smaller, more manageable parts. In theory,
when problems are dismantled into smaller pieces, they
are easier to understand. Under stress, an emotional side
effect of critical thinking is that smaller pieces of stressful
stimuli may be considered less threatening to the ego and
thus help to minimize emotional pain. In practice, though,
when critical thought pro cesses are directed toward the self,
judgmental and analytical thoughts often nurture a negative
perspective about yourself, making you more vulnerable to
the perceptions of stress ( BOX 9.1 ). When threatened,
critical thought can become a defensive weapon to protect
the components of your identity. In addition to critical think-
ing, a common mental attitude seen in American culture is
victimization. Victim ization is a perceptual attitude wherein
one feels specifically targeted by events or circumstances and
has no choice but to suffer the consequences. In dividuals
who see themselves as victims often seek pity and sympathy
from their friends as a means of coping with the stressors at
hand. Through the sympathy of others, they validate their
own perceptions of personal violation. People who express
feelings of victimization apply what psychologists refer to
as attribution theory, blaming other people or factors for
perceived injustices (Taylor, 2011).
The concept of victimization is closely associated with
Rotter’s concept of locus of control, where people who
Neurolinguistic programming (NLP): A program designed to look at how our thoughts control our lan-guage and how our language influences our behavior.
Victimization: A mindset of continually seeing your-self as a victim.
220 Part 3 Coping Strategies
life’s victims (a characteristic of codependency) often see
themselves as martyrs. This is a socially rewarding role,
so they find it difficult to change their perceptions.
Can optimism be learned? According to Martin Selig-
man the answer is yes! In his much-acclaimed book
Learned Optimism, Seligman states that we are most likely
to learn the traits of optimism or pessimism from our
parents, but even if the environment in which we were
raised was a negative one, we can cultivate the aspect of
optimistic thinking and gravitate toward a positive ap-
proach to life. Seligman studied several nationally ranked
swimmers prior to the 1988 Olympics and soon realized
that optimism is not only an inherent trait, but one that
can be augmented or learned. Using a term he coined,
feel violated by stressors are more greatly influenced
by external sources than by internal strength and
inspiration. Here is a simple test to detect use of the vic-
timization attitude: During the next casual conversation
you encounter, listen objectively to what is said and notice
how often people appear to fall victim to their bosses,
spouses, roommates, kids, traffic, the weather, or any other
circumstance in the vicinity. Next, listen objectively to how
you present your perceptions to others when you describe
your own levels of stress. Do you consciously or uncon-
sciously label yourself as a victim? Many people take great
comfort in being a victim because it fulfills an immediate
need to feel needed, as well as the instant gratification of
sympathy and pity. People who take on the role of one of
BOX 9.1 Cognitive Distortions: Stop the Insanity!
The human mind can be our greatest asset or our worst liability. Under the influence of the ego, the mind becomes misguided and heads down a path of self-sabotage. All of this is exacerbated in times of stress. This behavior in psychological circles is known as cognitive distortion. It can be said that cognitive distortions are spin-offs of Freud’s defense mechanisms. More than the ego’s intent to decrease pain or increase pleasure, over time these distor-tions become a habitual mindset that can sabotage our best efforts. David Burns writes in great detail about this phenomenon in The Feeling Good Handbook where he describes the ten distinct styles of cognitive distortion that perpetuate perceptions of stress. Mental thought pro-cesses and the behaviors they elicit cannot be changed until they can first be identified. (It should be noted that the benefit of meditation is to become the observer of your thoughts.) As you read through this list, ask yourself if one or more styles sound all too familiar to your way of stress-based thinking. If you don’t see these in yourself, ask a trusted friend to give you feedback.
1. All-or-none thinking: There is only good or bad, black or white, no middle ground (e.g., there is only one way to solve this problem).
2. Overgeneralization: One single negative circum-stance manifests into a life pattern (e.g., A flat tire elicits the comment, “This always happens to me!”).
3. Mental filter: A solitary negative detail becomes the focus of your attention, obscuring the bigger picture (e.g., an hour drive is tainted by one driver early on who cut you off).
4. Disqualifying the positive: A negative belief pat-tern that eclipses positive circumstances, reduc-ing any that surface as insignificant all the while focusing on the negative.
5. Jumping to conclusions: Affirming a negative interpretation without supporting facts often by insisting on a strong intuitive feel, which is little more than projection of one’s own feelings.
6. Magnification: The classic story of making a mountain out of a mole hill, by exaggerating facts with the end result in a myopic vision of the situation and thus missing the big picture.
7. Emotional reasoning: Living the assumption that one’s negative emotions are a true reflection of how things really are.
8. Should statements: A thought process influenced by a “rewards and punishment” mentality in which one motivates oneself with the words should, must, ought. This behavior often results in feelings of guilt or resentment toward others.
9. Labeling and mislabeling: Considered an extreme form of overgeneralization, statements such as “I’m a loser,” or “He’s always a jerk,” are exam-ples in which mislabeling involves words that are highly charged or emotionally loaded.
10. Personalization: Taking credit or blame for events that you had little or nothing to do with.
Chapter 9 Cognitive Restructuring: Reframing 221
flexible optimism, Seligman states that although the trait
of optimism is not a panacea for the bumps in the road of
life, we can harness the power of positive thinking to help
us achieve our goals and promote a greater state of health
and well-being ( FIG. 9.3 ).
The dialogue mentioned earlier that seems to run non-
stop in our minds is referred to as self-talk, and it has
been observed that the preponderance of this is negative
self-thoughts. Schafer (1999) has identified several types
of negative self-talk thinking patterns that produce and/
or perpetuate the toxic-thought process. He lists them
in the following categories: pessimism, or looking at the
worst of almost every situation; catastrophizing, making
the worst of a situation; blaming, shifting the responsi-
bility for circumstances to someone other than yourself;
perfectionism, imposing above-human standards on
yourself; polarized thinking, where everything is seen
as an extreme (good versus bad) and there is no middle
ground; should-ing, reprimanding yourself for things you
should have done; and magnifying, blowing problems
out of proportion.
One technique to convert negative thoughts to
neutral thoughts, similar to Ellis’s REBT, is called
thought stopping. When you catch yourself thinking
negatively, you interrupt the flow of conscious ness and
say to yourself, “Stop this thought.” With practice,
thought stopping can help to disarm your negative critic
and give balance to your emotional thoughts.
As you can see, toxic thoughts are very real. Over time,
these can have consequential effects on the body as well.
But stimulation received by the brain is open to reinter-
pretation, and perceptions can change. Metaphorically
speaking, some people appreciate the beauty of the rose
petals, some people sense the pain of the thorns. Cog-
nitive restructuring is a way to focus on the rose petals.
Here is the lesson: Every situation has a good side and a
bad side. Each moment . . . you decide! During World
War II, a song by Johnny Mercer and Harold Arlen hit
the air waves and quickly became a national hit. It was
called “Accentuate the Positive, Eli minate the Negative,”
and this song was one of many credited with helping the
nation deal with the consequences of war ( FIG. 9.4 ).
■ The Choice to Choose
Our Thoughts
In his book Man’s Search for Meaning, Frankl credited
his survival in Auschwitz to his ability to find meaning
in his suffering, a meaning that strengthened his will-
power and choice of attitude. Frankl noted that despite
the fact that prisoners were stripped of all their material
possessions and many essential human rights, the one
thing concentration camp officials could not take away
was the ability of prisoners to choose their perceptions
of their circumstances.
Flexible optimism: A term coined by Seligman to convey that we can all harness the power of opti-mism into positive thinking.
Self-talk: The perpetual conversation heard in the mind, usually negative and coming from the critical (ego), which rarely has anything good to say.
Pessimism: Looking at the worst of every situation.
Catastrophizing: Making the worst out of every situation.
Blaming: Shifting the responsibility of a problem away from yourself.
Perfectionism: Perpetually imposing above-human standards on oneself.
Polarized thinking: A condition where things are always viewed in extremes, either extremely good or horribly bad.
Should-ing: Reprimanding yourself for things you “should” have done.
Magnifying: A term to describe blowing things out of proportion.
Thought stopping: A coping technique where one consciously stops the run of negative thoughts going through one’s head.
FIGURE 9.3
© Randy Glasbergen, used w
ith permission from
ww
w.glasbergen.com
.
222 Part 3 Coping Strategies
meaning in the suffering) and then move on to personal
resolution and growth. When many people are introduced
to the concept of cognitive restructuring, they incorrectly
sense they must adopt a “Pollyanna” or cheerful attitude and
that grief is not an appropriate sensation to acknowledge.
As a result, they reject the entire idea of looking at the
“brighter side” of a situation. Until feelings of suffering, no
matter how big or small, are brought to awareness, it will
be difficult to adopt a new frame of mind. Frankl wrote
that even in suffering there can be tragic optimism; the
discovery of light-hearted moments and personal mean-
ing in the saddest of times. Even in the death-grip of the
concentration camp, Frankl found it possible to laugh at
many of life’s absurdities. Moments like these helped him
get through his ordeal.
Comparisons between war and sports are not uncommon.
A winning attitude is everything. Tennis champion Andre
Agassi explained his reframing style from an athlete’s
perspective in his best-selling book Open: “I’ve won 869
matches in my career, fifth on the all time list, and many
were won during the afternoon shower.”
In her classic book Minding the Body, Mending the Mind,
Borysenko refers to the preponderance of negative thoughts
as awfulizing. The process of awfulizing consists of judg-
mental and analytical thoughts that greatly narrow one’s
perspective and put our mental processes into a shallow,
one-track mode. The result is what Borysenko calls re-
gressive coping, a nonproductive coping skill. Awful izing
creates worst-case scenarios for every situation. Although it
is good to prepare for all possibilities, a worst-case scenario
is only one in a wide spectrum of possibilities.
Psychologists use the term self-fulfilling prophecy to describe
the link between perceptions/beliefs and their related
behaviors. The self-fulfilling prophecy can work to one’s
advantage as well as one’s disadvantage. Sports events are
filled with stories of athletes who believed they were winners
and proved that indeed they were. In highly competitive
events like the Olympics, the difference between a gold
medal and a silver or bronze is not only a super lative athletic
body, but an accompanying winning attitude. Many an
athlete has lost an event, and thus failed to meet an expec-
tation, because a seed of self-doubt took root somewhere
between the starting block and the finish line. Individuals
who harbor negative thoughts about themselves or the
situations they encounter promote behaviors generated by
these perceptions. The result can be a negative cycle that
sets the stage for recurring stressful perceptions and what
appears to be a stagnant black cloud over one’s head; this
is the fulfillment of the self-fulfilling prophecy.
FIGURE 9.4 In this photo, a recording of opera singer Luciano Pavarotti is projected into a small sample of water. The wave trains in the water reveal the delicate harmonic pattern of the audio frequencies of his voice. From this, and many similar images, one can begin to appreciate the impact (either harmonious or discordant) that spoken words and even our thoughts—which are more subtle forms of vibration—can have on our bod-ies, which are composed mostly of water.
Brief grief: A concept that suggests that some grieving is appropriate and healthy, versus unhealthy, prolonged grieving.
Awfulizing: A mindset where one tends to see (or hope for) the bad in every situation.
One concept that evolved from Frankl’s theory of logo-
therapy is brief grief, which means acknowledging and
mourning an unmet expectation but not prolonging the
grieving process beyond a reasonable period of time. Death-
education experts suggest there are three basic stages of
grief: shock (denial), anger (depression), and understanding
(acceptance). The time for each stage will vary depending
on the person as well as the magnitude of loss. Feelings of
loss, sadness, anger, pain, and fear are all natural, but not
for prolonged periods of time. To deny these feelings is
unhealthy, just as it is abnormal to prolong these feelings
beyond their purpose. Brief grief is a strategy to allocate
the correct amount of time to the grieving process (finding
© 2002 Alexander Lauterw
asser. Reprinted with perm
ission from W
ater Sound Images.
© 2005 M
ACROmedia Publishing, Eliot, M
E. Availabe at: ww
w.cym
aticsource.com.
Chapter 9 Cognitive Restructuring: Reframing 223
An example of this concept occurred in the 1990 hit movie
Pretty Woman, when actress Julia Roberts, in the role of
a Hollywood hooker, described to actor Richard Gere
how she fell into her “career rut.” She stated that while
growing up she received a lot of negative feedback from
her parents and peers, and that these were so much easier
to believe, eroding her self-esteem. Another example is
John Travolta’s character, Edna Turnblad, in the movie
Hairspray; he plays an overweight woman who refuses
to leave the house for many years because of her struggle
with obesity. This “underdog” trait in both Roberts’s and
Travolta’s characters was one many audience members
could identify with and relate to, perhaps because this
attitude is so prevalent in American society.
To break this self-defeating thought cycle, Borysenko
suggests employing the concept of reframing. Reframing
involves looking at the same situation from a new refer-
ence or vantage point and finding some good aspect in it.
Quite often, stubbornness and the comfort of our own
opinions become obstacles to the reframing process. Tools
to initiate the process and dismantle the obstacles include
the use of humor, positive affirmations, and creativity.
Positive affirmations are designed to bolster self-esteem.
Confidence building through self-praise in the form of
positive feedback tends to counterbalance the voice of the
inner critic constantly telling us we’re not up to standards
when we compare ourselves with others.
For example, as a health promotion and stress-management
consultant, I meet many people from all parts of the country
and all walks of life. During one workshop in 2007, I met
a remarkable woman from New Orleans who shared her
story of the terrible devastating experience she endured
(and continues to endure). My interactions with her and
others from New Orleans have allowed me to experience
first-hand the expression of the hardy personality, which
scholars Kobassa and Maddi describe as the stress-resistant
personality. Here is Chris’s story:
Chris is a native New Orleanian. It is a city she loves
with a passion. From the Dixieland jazz and Mardi
Gras to Cajun cooking, New Orleans is loaded with a
unique culture all its own. Living on the Gulf Coast,
however, has its perils. Louisiana is no stranger to
hurricanes. They are as much a given, Chris said, as
snow storms are in New England. When Katrina was
forming in the Gulf of Mexico, Chris and her hus-
band boarded up the house, packed up the car, and
headed north to Baton Rouge. With gale forces up to
150 miles per hour, they expected some wind damage
to the house, but no one expected the levees to break
and cause massive flooding. When they were allowed
to go back to their home weeks later, they found
water damage clear up to the second floor. Chris lost
priceless heirlooms, family portraits, computers, and
a manuscript of a book she had been working on for
5 years—practically everything she owned.
To lose everything in a flood can be devastating. How
do you rebuild your life at the age 35? Chris said it
would have been easy to play the role of victim, but
what good would that serve? “You take stock of what
you do have and build from there. I may have lost my
house and my belongings, but I have my health and my
wits. I am resilient. I will get through this, and I am
determined not to give up, but to rise above the situa-
tion and move on.” And that she has. Rebuilding her
life and rebuilding her house move on parallel tracks,
but within a year’s time she regained her sense of bal-
ance. She says, “Losing everything is both devastating
and liberating. I chose to focus on the positive and that
is what has gotten me through the tough times.”
One final thought about reframing ( FIG. 9.5 ). Bor-
ysenko recounts the story of an Australian friend, Ian
Reframing: The name given to the thought process where a negative perception is substituted for a neu-tral or positive one, without denying the situation.
FIGURE 9.5 According to some experts, the unconscious mind does not acknowledge negative thoughts. Thoughts such as “I won’t get nervous,” are interpreted as “I will get nervous,” which then often results in nervous behavior. Thinking positively allows the conscious and unconscious minds to work together.
Conscious
Unconscious
The unconscious mind does notunderstand negative thoughts
224 Part 3 Coping Strategies
Gawlen, who was diagnosed with bone cancer and given
2 weeks to live. This man adopted the attitude that if he had
2 weeks to live, he was going to make the best of it. So, he
proposed to his girlfriend, got married, and went off on a
honeymoon to the South Pacific. Twenty years later, telling
of his experiences to Borysenko, he explained why he was
still alive. He discovered for himself that the unconscious
mind does not respond to negative thoughts such as “can-
not,” “won’t,” and “don’t.” There fore, rather than telling
himself, “I cannot die,” which the unconscious mind would
understand as “I can die,” he fed himself a flood of positive
thoughts, such as “I will live,” and he has ( BOX 9.2 ).
■ Acceptance: An Alternative
Choice
Many times we encounter situations we have no abil-
ity to control: a manipulative boss, an obnoxious
Acceptance: Often the final outcome of reframing a situation: Accepting that which you cannot change and moving on with your life.
Serenity Prayer: A popular short prayer encourag-ing acceptance and wisdom, attributed to Reinhold Niebuhr.
BOX 9.2 Optimism and Pessimism
Over the years I have asked my students for their defi-nitions of optimists and pessimists. All clichés aside, here are some of their answers:
An optimist is someone who:
■ doesn’t let failure limit his growth as a human being.
■ can find redeeming qualities in just about everyone.
■ takes personal setbacks as only a temporary inconvenience.
■ counts blessings instead of misfortunes.
■ loses a job and says there is a better one waiting.
■ has the ability to reevaluate her expectations so as not to become depressed when she falls short.
■ describes a pessimist as a person with potential.
■ continually explores new areas of life and can accept others who are different as unique.
■ has enough faith in herself to see her through a crisis.
■ on his deathbed, says, “I have no regrets.”
A pessimist is someone who:
■ cannot accept opposing viewpoints or thoughts as valid.
■ enjoys nothing more than finding out that his nega-tive view is right.
■ typically prejudges and pigeonholes others before getting to know them.
■ delights in Murphy’s law that anything can and will go wrong, at the worst possible moment.
■ constantly sees obstacles in her way, which are usually put there by herself.
■ gains energy by drawing on a negative perspective.
■ claims to be a realist, but he’s not fooling anybody.
■ describes an optimist as being out of touch with reality.
■ not only has a black cloud of negativity over her head, but created the thunderhead as well.
roommate, or a significant personal loss. The reality
of the situation is not pleasant in the best of moments.
A common theme found among the theories of many
psy cho logists in these cases is acceptance. The accep-
tance of situations we have no control over is thought
to be paramount as a stress-management strategy, yet
it is perhaps the hardest frame of mind to adopt. There
is a fine line between control and acceptance. This is
the essence of Reinhold Niebuhr’s Serenity Prayer for
Al co hol ics Anony mous: “Lord, grant me the serenity to
accept the things I cannot change, the courage to change
the things I can, and the wisdom to know the differ-
ence.” Acceptance is not an “overnight sensation,” but
rather an attitude that may take several days, weeks, or
months to adopt and implement. Often, acceptance involves
some aspect of forgiveness. The concept of acceptance is
very similar to one described by Lao Tzu in the Tao Teh
Ching. Lao suggested that we move in rhythm with the
universal energy, not against it. Denial and manipula-
tion, like spinning car wheels in the dirt, prove fruit less
because they go against the rhythm of natural energy.
Swimming against the tide can prove exhausting, and
sometimes fatal. As the saying goes, sometimes it takes
more strength to let go than to hang on. Finally, the use
of acceptance or forgiveness appears to be a greater tool
in the face of anger than of fear.
Chapter 9 Cognitive Restructuring: Reframing 225
There have been thousands of empirical studies to
determine the effectiveness of cognitive restructur-
ing on health-related problems associated with stress.
These studies have focused on both mismanaged anger
(coping skills for men who battered their wives and
children) and anxiety disturbances, most notably sub-
stance abuse and eating disorders. The results of these
studies indicate that thought processes can be changed
to produce a better state of health, although this is not
effective in all cases.
■ Steps to Initiate
Cognitive Restructuring
A simple, four-stage process introduced by the field of
behavioral medicine is a model for implementing changes
in lifestyle behaviors through cognition to promote health.
The following model explains how cognitive restructur-
ing can be implemented as a coping technique to reduce
stress. Initially, this pro cess does not appear to take a lot
of time. Thoughts last less than seconds, yet they may
resurface often in the course of a day. And the feelings
these perceptions generate can last for days and weeks.
A closer look suggests that cognitive restructuring is a
refinement of the continuous dialogue of the mind, and
as a result is, for the most part, an ongoing process. The
stages are as follows:
1. Awareness: The awareness process has three
steps. In the first, stressors are identified and
acknowledged. This may include writing down
what is on your mind, including all frustrations
and worries. The second step of the awareness
process is to identify why these situations and
events are stressors and, more specifically, what
emotional attitudes are associated with each. In
the last step, a primary appraisal is given to the
main stressor and acknowledgment of the feel-
ings associated with it. If the original perception
appears to be defensive or negative, and inhibits
you from resolving this issue, then the next stage
is reappraisal.
2. Reappraisal of the situation: A secondary appraisal,
or reappraisal, is a “second opinion” you generate in
your mind to offer a different (objective) viewpoint.
A reappraisal is a new assembly or restructuring
of the factors involved, and the openness to ac-
cept a new frame of mind ( FIG. 9.6 ). At this
stage, a second or third opinion involves choosing
a neutral, or preferably positive, stance to favorably
deal with the issues at hand. Remember, a new
appraisal isn’t a rationalization process, nor is it a
suppression of emotions. Also, remember exactly
what factors you can control and what you must
accept as out of your control.
3. Adoption and substitution: The most difficult part
of any attitudinal change is its implementation.
Once a new frame of mind is created, it must then
be adopted and implemented. Humans tend to
be creatures of habit, finding comfort in known
entities even if the “known” is less than desirable.
Pessimism is a defense mechanism, and although it
is not seen as enhancing human potential, there is
comfort in the familiarity of old ways, and change
does not come easily. There are risks involved in
change. Substituting a positive attitude for a nega-
tive perception may make you feel vulnerable at
first, but like other skills that improve with prac-
tice, a new comfort will emerge. With cognitive
restructuring, the new mind frame must often be
substituted when the stress is encountered, and
repeated again and again.
4. Evaluation: The test of any new venture is to
measure its effectiveness. Did this new attitude
work? Initially, it may not. The first attempt to
shoot a basket through the hoop may result in
an embarrassing miss. Evaluate the new attitude
and decide how beneficial it was. If it turns out
that the new mind frame was a complete failure,
return to stage 2 and create a new reappraisal. If
the new mind frame worked, repeat this process
with stressors that demand a change in attitude
to resolve and bring closure.
FIGURE 9.6
© Randy Glasbergen, used w
ith permission from
ww
w.glasbergen.com
.
226 Part 3 Coping Strategies
■ Some Additional Tips for
Cognitive Restructuring
1. Initiate a relaxation technique to calm your mind.
When a relaxation technique is employed, the
mind begins to unwind and consciousness shifts
from an analytical mode to one of receptivity. In
this unwinding process, unimportant thoughts
begging the conscious mind for attention are
dismissed, allowing greater receptivity to a wider
perspective on the issue at hand. A wider perspec-
tive in turn fosters personal enlightenment and
opens up room for positive thoughts.
2. Take responsibility for your own thoughts. In times
of stress we may feel victimized. We may also feel
that things are out of our control. A way to gain
temporary control is to blame others for the personal
injustice of the perceived stressor. Blame is associated
with guilt and guilt can be a toxic thought. If you
find yourself blaming others for events that make
you feel victimized, ask yourself how you can turn
this blame into personal responsibility for your own
thoughts and feelings without feeling guilty.
3. Fine-tune expectations. It is believed to be easier
to refine expectations prior to meeting a stressor
than to reframe an attitude after the fact. Many
times we walk into situations with preconceived
expectations. When these expectations are not
met to our satisfaction, then negative feelings are
generated. Fine-tuning expectations doesn’t mean
abandoning ideals or lowering self-esteem. Rather,
it means running your perceptions through a real-
ity check, questioning their validity, and allowing
them to match the given situation.
4. Give yourself positive affirmations. The constant
internal conversation going on within the conscious
mind tends to be dominated by negative thoughts
generated by the ego to defend itself. Although
created with good intentions, a preponderance of
negative self-feedback erodes self-esteem. Positive
affirmations balance this internal conversation
with good thoughts to enhance self-confidence and
self-esteem. Repeat a phrase to yourself that boosts
your self-esteem (e.g., “I am a lovable person” or
“I am a winner”).
5. Accentuate the positive. There is a difference between
positive thinking and focusing on the positive. Posi-
tive thinking is an expression of hope concerning
future events. It is often characterized by setting
goals, wishful thinking, and dreaming. Although
positive thinking can be healthy, done to excess it
can be a form of denial. Focusing on the positive is
reframing the current situation. It is an appreciation
of the present moment. Acknowledge the negative.
Learn from it, but don’t dwell on it. Focus on the
positive aspects and build on them.
Best Application of Reframing
When you find yourself stressed out and are perhaps
entertaining toxic thoughts, first identify what makes
you stressed, and then ask yourself why you feel this
way. Get in the habit of then asking yourself, “What
good can come from this situation?” In other words,
what positive aspect can you learn from that which
stresses you out? Recognize what feelings of anger and
fear surface, and then shift your thinking to a proactive
stance so you do not become the victim of your own
thoughts and perceptions.
Chapter 9 Cognitive Restructuring: Reframing 227227
1. What is the thinking process model?
2. What role does the unconscious mind play in
changing behavior?
3. How can you best describe toxic thoughts?
4. List the steps to initiate cognitive restructuring.
5. What is cognitive restructuring?
6. What role does the unconscious mind play in the
process of restructuring?
7. What effect does attitude have on human
physiology?
STUDY GUIDE QUESTIONS
SUMMARY ■ All stimuli received by the brain are processed through
interpretation and classified as negative, neutral, or
positive; this process is called perception.
■ When the interpretation is exaggerated, it is referred
to as cognitive distortion.
■ Cognitive restructuring means changing a percep-
tion from a negative interpretation to a neutral or
positive one, making it less stressful. This process
is also called reappraisal, relabeling, reframing, and
attitude adjustment.
■ The seeds of this coping technique were planted by
Ellis in rational emotive behavior therapy (REBT);
the term cognitive restructuring was coined by
Meichenbaum in 1975.
■ The information-processing model describing how
stimuli are interpreted consists of four components:
sensory input, sensory manipulation, cognitive/be-
havioral output, and a feedback system.
■ Negative thoughts are often called toxic thoughts.
Research has now substantiated the hypothesis that
negative thoughts can suppress the immune system.
■ Negative thoughts are a conditioned response, starting
as early as childhood, to negative feedback given by
parents, which is transformed into guilt and shame.
■ Toxic thoughts come in various styles, including
pessimism, catastrophizing, blaming, perfectionism,
polarized thinking, should-ing, magnifying, and
self-victimizing.
■ Frankl brought to light the fact that we have the abil-
ity to choose our own thoughts, to alter our thinking
process and adopt new perspectives.
■ Borysenko calls creating negative thoughts “awful-
izing,” and explains that the way to change these
thoughts is through reframing, wherein the stressful
event is reframed in a positive light.
■ Positive psychology is an emerging field that focuses
on using human attributes to cope with stress.
■ When there seems to be no positive light available,
acceptance of the situation (not to be confused with
giving in) is suggested. Acceptance means to go with,
rather than against, the flow that you cannot control.
■ A four-point plan to reconstruct negative thoughts
includes the following: (1) awareness, (2) reappraisal
of the situation, (3) adoption of a new frame of mind,
and (4) evaluation of the new mind frame.
■ Additional hints for cognitive restructuring include
meditation to clear your mind, taking responsibility
for your own thoughts, fine-tuning expectations, giv-
ing yourself positive affirmations, and accentuating
the positive aspects of any situation.
228 Part 3 Coping Strategies
Agassi, A. Open. Vintage Books, New York, 2010.
Albom, M. Tuesdays with Morrie. Broadway Books, New
York, 2002.
Allen, R. J. Human Stress: Its Nature and Control. Burgess
Press, Minneapolis, MN, 1983.
Anderson, M. D., and Williams, J. M. Seeing Too Straight:
Stress and Vision, Longevity, August 1989.
Andreas, C., with Andreas, T. Core Transformation: Reaching
the Wellspring Within. Real People, Moab, UT, 1994.
Andreas, S., and Faulkven, C. (eds.). NLP: The New
Technology of Achievement. Quill Books, New York, 1994.
Bandura, A. Self-Efficacy: The Exercise of Control. W. H.
Freeman, New York, 1997.
Beck, A. T. Cognitive Therapy and Emotional Disorders. Inter-
national Universities Press, Ann Arbor, MI, 1976.
Borysenko, J. Minding the Body, Mending the Mind. Bantam
Books, New York, 2007.
Burns, D. The Feeling Good Handbook. William Morrow and
Co., New York, 1989.
Canfield, J. Self-Esteem and Peak Performance. Vantage Com-
m unications, Nyack, NY, 1988.
Chamine, S. Positive Intelligence. Greenleaf Book Group Press.
Austin, TX, 2012.
Danner, D., et al. Positive Emotions in Early Life and Longevity:
Findings from the Nun Study, Journal of Personality and
Social Psychology 80:804–813, 2001.
Ellis, A. Reason and Emotion in Psychotherapy. Carol Publishing,
New York, 1996.
Frankl, V. Man’s Search for Meaning. Pocket Books, New
York, 1974.
Frederickson, B. Love 2.0. Penguin Books. New York. 2013.
Frederickson, B. The Science of Love. Aeon Magazine. March
15, 2013. http://www.aeonmagazine.com/oceanic-feeling/
barbara-fredrickson-biology-of-love/.
Frederickson, B. The Science of Love. Aeon. March 15, 2013.
https://aeon.co/essays/love-works-its-magic-in-mysterious
-biochemical-ways.
Hari, G. The Conscious, Unconscious and Super-Conscious Mind.
Jasmin Publishing House, Downy, CA, 2005.
Ingerman, S. How to Heal Toxic Thoughts. Sterling Books, New
York, 2012.
Janis, I. L. Stress, Attitudes, and Decisions. Praeger, New York,
1982.
Katz, S., and Liu, A. The Codependency Conspiracy. Warner
Books, New York, 1991.
Kaymen, L. P. Learned Helplessness, Cognitive Dissonance,
and Cell-Mediated Immunity. Doctoral dissertation, Uni-
v ersity of Pennsylvania, 1989.
Kleinke, C. Coping with Life Challenges. Waveland Press,
Prospect Heights, IL, 2003.
Kobasa, S., Maddi, S., and Kahn, S. Hardiness and Health:
A Prospective Study, Journal of Personality and Social
Psychology 42(1):168–177, 1982.
Lazarus, R. Stress and Emotions. Springer, New York, 1999.
Liberman, J. Light: Medicine of the Future. Bear & Company,
Santa Fe, NM, 1991.
Lipton, B., and Bhaerman, S. Spontaneous Evolution. Hay
House Books, Carlsbad, CA, 2009.
Meichenbaum, D. H. Cognitive-Behavior Modification.
Plenum Press, New York, 1977.
Meichenbaum, D. H. A Self-Instructional Approach to
Stress Management: A Proposal for Stress Inoculation. In
C. D. Spielberger and I. Sarsason (eds.). Stress and Anxiety,
vol. 2. Wiley, New York, 1975.
Mlodinow, L. Subliminal: How Your Unconscious Mind Rules
Your Behavior. Pantheon Books, New York, 2012.
Murphy, J. The Power of Your Subconscious Mind. Wilder Pub-
lications, New York, 2008.
Neisser, U. Cognition and Reality: Principles and Implications
of Cognitive Psychology. Freedom Press, New York, 1976.
Ornstein, R., and Sobel, D. Healthy Pleasures. Addison-
Wesley, Reading, MA, 1989.
Peale, N. V. The Power of Positive Thinking. Prentice-Hall,
New York, 1987.
Pettingale, K. W., et al. Mental Attitudes to Cancer: An
Additional Prognostic Factor, Lancet March 30: 750, 1985.
Positive Psychology Center at the University of Pennsylvania.
Homepage. www.ppc.sas.upenn.edu.
Pretty Woman. Orion Pictures, Los Angeles, CA, 1991. Film.
Rankin, L. Mind Over Medicine: Scientific Proof That You Can
Heal Yourself. Hay House, Carlsbad, CA, 2013.
Rankin, L. Scientific Proof That Negative Beliefs Harm Your
Health, 2013. www.mindbodygreen.com/0-9690/scientific
-proof-that-negative-beliefs-harm-your-health.html.
Rasmussen, L. Reinhold Niebuhr: Theologian of Public Life.
Augsberg Fortress Press, Minneapolis, MN, 1991.
Schafer, W. Stress Management for Wellness, 4th ed. Wadsworth,
Belmont, CA, 1999.
Seligman, M. Authentic Happiness. Free Press, New York, 2002.
Seligman, M. Learned Optimism. Knopf, New York, 1991.
Siegel, B. Love, Medicine, and Miracles. Perennial Press, New
York, 1987.
Steptoe, A., O’Donnell, K., Badrick, E., Kumari, M., and Mar-
mot, M. Neuroendocrine and Inflammatory Factors Associ-
ated with Positive Affect in Healthy Men and Women,
American Journal of Epidemiology 167(1):96–102, 2008.
Taylor, S. Health Psychology, 9th ed. McGraw-Hill, New
York, 2014.
Taylor, E. I Believe: When What You Believe Matters. Hay House,
Carlsbad, CA, 2013.
Whacker, W. The Visionary’s Handbook. HarperBusiness,
New York, 2001.
Wright, J. There Must Be More Than This. Broadway Books,
New York, 2003.
REFERENCES AND RESOURCES
Image © Brent Hofacker/Shutterstock.
Healthy boundaries promote great health; a lack of such
boundaries sets the stage for poor health and well-being.
Take a look around today and you will notice that there
are flagrant violations of healthy boundaries everywhere:
poor eating habits, rude technology habits, questionable
drinking habits, abysmal financial habits, and dysfunctional
relationships. The list goes on and on. Poor boundaries
often lead to a sense of victimization. At some point ev-
eryone trips and falls. Some people stay face down and
dig a hole, hit rock bottom, and keep on digging. Others
hit rock bottom and decided to make a course correction,
get out of the hole, stand up, and start walking again.
Healthy boundaries are guidelines for healthy living,
and behavior modification is the strategy to keep you on
the road, rather than driving off a cliff. The key to life is
structure and flexibility, that is, healthy boundaries and
behavior modification.
Good parents give their children healthy
boundaries, essential rules to live by, such
as “Eat your vegetables,” “No phone calls
after 9:00 p.m.,” “Dessert comes after dinner,
not before,” and so on. Simply stated, healthy boundar-
ies are codes of appropriate and responsible behavior
that one should follow to live a healthy and productive
life. We learn these boundaries from our parents and/or
loved ones as we grow up. But as we mature into adults
we must create and maintain our own adult behaviors.
Consider basic cell physiology as a metaphor for healthy
boundaries: Each cell has a cell membrane, a gatekeeper
to keep things in that must stay in (e.g., nucleus, DNA)
and keep those things out that do not belong inside the
cell, while regulating what comes in (oxygen) and what
leaves (waste products). Healthy cells have great cell
membranes. Cells with impaired cell membranes have
all kinds of problems. Human beings are no different.
Healthy Boundaries: Behavior Modification
How many psychiatrists does it take to change a
light bulb? One, but the light bulb has really
got to want to change.—Anonymous
CHAPTER 10