Act One: Thought Replacement
I am standing in the doorway of a cabana beside the Colorado River, only a mile or two from where it empties into the Gulf of Mexico in Matagorda, Texas. My father helped build it, and the adjacent river house, both owned by family friends. In the evenings, dozens of wild hogs emerge from the salt grass and marshes across the river to drink. It’s not particularly beautiful, but it nonetheless instills a sense of peace in me.
I could stand in this doorway and watch this water go by for the rest of my life, I think.
Since that day, when I’m trying not to slip into rumination or other negative thoughts, I sometimes try think instead about standing in that doorway in the cabana.
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Act Two: Distraction
I am convinced that there is no more content human than a man with a task. Our schedule in this household is such that I prepare many of our suppers. I cook reasonably well, and take pride in keeping tabs on what we have, reducing waste, and food prep.
The knives in the block are sharp, and my favorite is the one called a Santoku. As I slice onions, squash, or other ingredients, I am in peak mindfulness. My mind is nowhere else while I render evenly-sized pieces of whatever I am slicing. Knuckles forward, fingertips tucked, I move the knife in even strokes. For the duration of my task, I am thinking of nothing else. I feel at peace.
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Act Three: Thought Stopping
It is November of 2020, and I am severely depressed. This sometimes happens when I awaken from anesthesia. This particular week, I’ve had to go the emergency room, where I am briefly anesthetized. Medically, I am fine, but I awaken to a severe depressive episode, which I am fighting with everything I have:
When I feel compelled to isolate, I socialize.
When I feel compelled to skip activities of daily living (showering, basic hygiene, etc), I tend to them in detail.
When my thoughts obsessively repeat dreadful untruths, I tell them to STOP.
We need Thanksgiving decorations, and I volunteer to go to the store for them. Wearing a Covid mask, I shuffle down the aisles. While I search for wicker pumpkins, under my breath I am telling my negative thoughts “stop, just stop it,” “we’re not doing this,” and a couple of curse word-laden phrases. Here and there I fear other shoppers can hear me.
By the next day, I am better, and don’t have another such spell (for any reason) for years.
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When I got my master’s degree, I entered this field intending to practice solution-focused brief therapy and narrative therapy primarily. Once I entered the workforce, though, I learned that most employers want a counselor to use cognitive behavioral therapy.
I’ve grown to love CBT over the years, as it emphasizes a logical, seemingly endless set of tools for analyzing our negative automatic thoughts (NATs). Still, among CBTs simplest tools are thought replacement, distraction, and thought stopping. Plenty of psychoanalysis occurs in a counselor’s office, but remember that some of the most effective tools available need not be complicated.
