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SMART Goals For Social Anxiety
What is Social Anxiety?
Social anxiety at its core is a fear of negatively evaluation. People with social anxiety are worried that they will do something to embarrass themselves and other people will judge them: “they are stupid”, “they are so boring”, “I can’t believe they did that” are a few worries that people with social anxiety struggle with in their daily lives.
As a result of social anxiety, these people might avoid social situations or endure them with great distress. For example, avoiding starting conversations with strangers, leaving a class if there are too many people, or deciding to never do a work presentation even if it would lead to a promotion.
Of course, one goal for these folks is to reduce their anxiety about negative evaluation. Because other people exist and sometimes they will judge. We all experience judgement from time to time.
Using exposures to reduce anxiety
Exposures are a great science-backed way to reduce anxiety. In exposures, we essentially put ourselves in anxiety-provoking situations to 1) reduce our fear over time because we see that most of the time, the feared consequence doesn’t happen and 2) understand even if the scary thing happens, that we can cope better than we thought.
Typically, you start with less challenging exposures and work your way up the hierarchy of fears. For example, if you have a fear of dogs, you might start by looking at pictures of a dog. Eventually, you’ll make your way up to physically interacting with a dog. Start small and build.
SMART Goals to plan exposures
SMART Goals – Specific, Measurable, Actionable, Realistic, Time-Bound – are an excellent way to plan out exposures and make them specific enough to act upon and realistic to successfully complete. We want to set ourselves up for success and SMART goals are helpful in that regard.
A few examples of SMART goals:
- Take a 15-minute walk twice a week
- Practice piano every day for 10 minutes
- Go to bed before midnight at least 5 times this week
- Write down 3 things you are grateful for in the evening
A few examples of non-SMART goals:
- Be happier (not specific)
- Become less anxious about social situations (not actionable)
- Spend more time with friends (not time-bound, meaning that you could start today, or you could start next year)
- Run a marathon tomorrow, if you haven’t run in the last decade (not realistic)
In the coming sections, we’ll talk about a few SMART goals you can plan to support your goal of reducing social anxiety.
But first, it’s important to understand the causes of social anxiety, so we can plan our SMART goals to support this overall goal.
Two causes of social anxiety: skills vs anxious thoughts
In the beginning, we discussed social anxiety as a general fear of negative evaluation.
There are generally two causes of negative evaluation: 1) skills-based deficits and 2) anxiety-based deficits. Put simply, in the first scenario, the person simply sucks at social situations. They don’t know when and how to smile, maintain eye contact, continue a conversation, all the little things that allow a conversation to flow well. There is a skills deficit.
In the second scenario, the person has the skills; but their anxiety makes hard for these skills to show because they are so worried about how they are coming across to the other person.
Therefore, SMART goals for skills-based deficits should work to improve important social skills. SMART goals for anxiety-based deficits should work to better tolerate anxiety in social situations and reduce stress. Consider which one you are before thinking about which SMART goals to set for yourself!
Examples of SMART goals in social anxiety
Without further exposition, here’s a few SMART goals that can be helpful for either instance of social anxiety:
Skills-based SMART Goals:
- Maintain eye contact long enough to notice the other person’s eye colour
- Ask at least 1 follow-up questions in your next conversation
- Reflect on one emotion the other person may be feeling, e.g., “You seem really happy/sad/excited about that”.
- Give a sincere compliment during a conversation
- Practice giving a presentation alone for 5 minutes about anything you want
- Read a book on social skills training for 10 minutes a day
Anxiety-based SMART Goals
- Complete a 5 minute relaxation exercise at least 3 times a week
- Smile and say hi to 5 strangers throughout the day
- Text a friend to hang out with you. If they say no, ask another person.
- Ask the cashier how their day is going
- Thank the bus driver
- Start a conversation with the Uber driver
- If your friends invite you out or to a party, say yes as an exposure
Again, choose a few that are challenging but manageable. You can make a list of SMART goals and categorize them as Easy, Medium, or Hard. As your anxiety reduces, you can make your way up the hierarchy and attempt more difficult goals!
Of course, facing your fears is never easy. To support you, here’s an interesting post on overcoming barriers when planning SMART goals.
Hope this was helpful!
Best wishes,
P
Photo credit: Image by wayhomestudio on Freepik
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5 Common Pitfalls In SMART Goal Setting And How To Avoid Them
SMART goal setting is a practical way to support mental health because it makes the abstract into the concrete.
Example: being happy is abstract. Spending more time with friends is concrete.
Therefore, SMART goals help us to operationalize what ‘happy’ means, which can be different from person to person. We can then plan actions and behaviours that are consistent with our goals in a specific, actionable, and achievable manner.
However, even with our best laid plans and high motivation, there are times when we never get to those SMART goals. We want to; it just never gets done.
Below, I discuss a few common pitfalls in SMART goal setting and some recommendations to get around these issues.
Problem #1. You can’t seem get started
At 3:00am when our motivation are at an all-time high, we feel ready to take that first step in changing our lives. At 3:00pm when our alarm clock tells us to go for that run, that motivation suddenly disappears. That run feels a lot more daunting than it did when we were hyped up at night.
When we have trouble getting started, it can mean that the first step is too big. For example, even if we think going out for a 15-minute run is no big deal, we feel stuck in our inertia and compelled to continue sitting on our couch.
Getting started is often harder than continuing an activity. It is therefore helpful to generate momentum by making the task even smaller. We can apply Newton’s laws here to our advantage: “objects in motion tend to stay in motion”. How can we make this jog even easier to start?
Well, we can start by just putting on our socks without the intention of running. After putting on our socks, we may notice that we have generated enough momentum to then put on our shoes. And then open the door. And then get out of the door. And then before we know it, we are 5 minutes into our 15-minute jog.
Recommendation #1: Make the first step as easy as possible.
The idea is to reduce friction as much as possible. Taking the example above, you might even place your running gear right next to your bed when you wake up, so you reduce the friction from getting out of bed to jogging. Or you might come home from work and immediately go out for the jog, so you don’t create unnecessary friction by sitting down and vegging out in front of your computer.
Recommendation #2: Reduce friction.
Problem #2. You constantly forget about the SMART goal
A second common issue that can occur is that we simply sometimes forget that we set the goal. Life gets in the way and our SMART goal gets lost among the hundreds of other things we have to do.
Unsurprisingly, having a written reminder about your goals can be helpful. That part is obvious and easy.
The harder part is remembering we wrote the reminder in the first place. Therefore, we need to make sure this reminder isn’t something extra we are putting on our mental load.
So, we want to place this note somewhere we always see in our day to day. For example, I always put my wallet on a specific counter. If I put my note there, I’ll encounter it without thinking about it.
Recommendation #3: If it’s not on the list, it doesn’t exist
Recommendation #4: Place your reminders somewhere you naturally frequent
Problem #3. You predict that it won’t help, so you don’t do it
Our minds can be our worst enemy. We try to plan something that might be helpful, such as spending some time with friends or taking a walk, but then our brain decides that it won’t be fun or the outing would be too exhausting. Then we don’t do it.
In these moments, it’s helpful to treat predictions like a curious scientist and engage in a behavioural experiment.
- Will the activity really have no effect at all?
- Will I really feel more exhausted if I go for that walk?
- Will I really not enjoy spending some time with my friends?
Okay, let’s test it. Sometimes our behaviours can precede our emotions after all.
Recommendation #5: Be curious and test the mind’s predictions.
Problem #4. You have trouble staying committed
“A person who has a why can bear almost any how” – Friedrich Nietzsche
In cases where you have difficulty staying the path, it’s helpful to remember why you started on this path in the first place: i.e., what are your values? What would engaging this SMART goal do to help you achieve things that are you important you? Whether it’s to live a more meaningful life, develop a stronger social circle, build a more confident self (or something entirely different altogether), remind yourself why you are on this path
Here’s an example:
Reasons to engage in the SMART goal: Spending 30 minutes every day engaging in a physical activity
- Help me to get into shape and feel more confident
- Be more active in my son’s life
- Allow me to travel without pain or getting tired too easily
- Reduce risk of heart disease
- Be able to help my parents as they get older
- Be happier and more energetic overall
Recommendation #6: Clarify your values and make a list on reasons to change.
Problem #5. You are setting too lofty goals
If you want to prepare for a marathon, you wouldn’t begin training by running a marathon. Depending on where you are at in your journey, you want to make sure your current SMART goals are achievable and realistic. Otherwise, you may find the changes in your habits to be too arduous and risk burning out.
To give an example: If you are dealing with social anxiety, you might start by just smiling and saying hi to the cashier. And as you train your conversation muscles, you’d then move to something more challenging, like striking up a conversation with a stranger.
Recommendation #7: Start small and build!
Summary
Overall, you’re making fantastic progress by simply getting started on SMART goals. I’ve listed a few pitfalls that sometimes make it harder for us to get started and a few recommendations to overcome them.
Good luck on your journey!
Best wishes,
P
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Simple SMART Goals To Improve Your Mental Health Today
When we think about changing our lives, completing large projects, or improving our mental health, we can often feel crushed by the mountain of work that seem to be needed to get to the finish line.
We then feel overwhelmed by this daunting beast and decide to retreat to something that reduces our distress but maintains our problems (e.g., watching TV, playing games, taking a nap).
It is therefore important to understand that the journey of a thousand miles really does begin with one step. And that first step can be made as simple as possible to set yourself up for success. Here, we can follow the adage: “if the action feels too difficult, then the step was too big”.
In this post, I provide examples of simple SMART Goals you can apply today to generate some momentum and hopefully improve your mental health.
What are SMART Goals?
Most of you already know what SMART Goals are (here’s a post on SMART Goals and how to use them if interested). In essence SMART Goals are: Specific, Measurable, Actionable, Relevant, and Time Bound.
When setting SMART goals, it is important for the goal to be something that you are likely to be able to complete and likely to provide you benefits (i.e., a good bang for your buck). You want to set yourself up for success as much as possible.
Below are some examples of possible SMART Goals. Choose and modify them as appropriate to make them feel more actionable. For example, you might reduce the time engaging in the activity or pair it with something naturally rewarding. And remember: the hardest part is getting started.
Examples of Simple SMART Goals in Different Domains
As discussed, you don’t have to do all of them; just one is great to get the ball rolling. You might even notice some more momentum as you go along.
Activating Behaviours
Sometimes we need to give a little to get a little. Activating behaviours help to increase our mood and energy by getting our body going. When we are tired, our body pulls for rest, so some of these goals can help break out of that cycle.
- Get out of bed in the morning within 5 to 10 minutes
- Sit by the window or going outside to get some sunlight
- Take a 5 to 10 minute walk
- Listen to one of your favorite songs
- Do 10 push-ups (can be modified if too difficult)
Productivity / Learning
Developing greater mastery and being productive in our world helps to foster a sense of self-efficacy. It is also an essential component of behavioural activation, which is an evidence-based therapy for depression.
- Read at least 1 page of a book
- Make your bed
- Take 5 minutes to clean your room or house
- Work 10 minutes on your project
- Complete one chore (e.g., laundry, shopping)
Social health
Human beings are innately social creatures; therefore, forming and maintaining social connections can be helpful to improve our overall mental wellbeing. For those who are a bit more introverted, here are a few goals that may be a bit more accessible.
- Ask out a friend for lunch
- Call a parent or loved one
- Smile and wave at one stranger throughout the day
- Ask the cashier how their day is going
General Health
Engaging in healthy behaviours make us feel better and increase our ability to tackle life’s problem. A few small things you can do today:
- Drink a glass of water
- Do a 5 minute yoga routine
- Make a healthy meal for yourself
- Go to bed on time
- Meditate for 3 minutes
Self-care
Life can be a constant source of stress which can deplete us if we are not nourishing ourselves properly. One way to increase our resources and reduce vulnerability is through self-care activities. I’ll give some examples below but you can be creative in personalizing small things you can do for yourself.
- Cozy up with a tea and a nice book/show
- Take a warm bath
- Try out a new restaurant you’ve been wanting to go to
- Smell some scented candles
- Engage in one of your hobbies (e.g., painting, making music)
- Writing down two or three things you are grateful for in your life (small or big)
Dealing with negative thoughts
When we are at a low point, it’s easy for negative thoughts and beliefs to invade our mind and act as barriers to engaging in SMART goals. For example, you might have thoughts like “it’s not going to help” and “this is just a drop in the bucket”, which can demotivate us from taking action.
When we are depressed or feeling low, it’s understandable for these thoughts to come out. During this time, it’s helpful to recognize that these thinking errors maintain our depression and may be considered thinking errors. For example, one common thinking error is emotional reasoning – this is when we think based on our emotions rather than based on facts. “I feel tired therefore I cannot clean my room”. In these cases, try to remember that our behaviours can often precede how we feel (e.g., we don’t feel like going to work but we do it anyways). Sometimes, once you get started you’ll notice that your emotion change too!
To deal with negative thoughts, a thought record can be a helpful tool to challenge our limiting beliefs.
Summary
Mental health is not defined by monumental accomplishments in our lives. Rather, it’s defined by the small habits that make up our day to day. I recognize that these goals may not solve existential crises, significant stressors, or very real systemic problems that may be the source of your problems right now, but I hope completing a few of these adds a little brightness to your day to day life.
Best wishes,
P
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5 Benefits Of Using The Downward Arrow Technique
The Downward Arrow technique is a common technique that therapists use particularly in cognitive behavioural therapy.
The downward arrow is an effective strategy to understand the core of a person’s fears or beliefs. The downward arrow techniques works by asking the question: “If that were true, then what?”. Let’s take an example:
Patient: If I don’t study multiple hours a day for an exam, then I will fail.
Therapist: If that were true, then what?
Patient: I would fail the course.
Therapist: If that were true, then what?
Patient: Then I would fail out of my degree.
Therapist: If that were true, then what?
Patient: Then I would not be able to find a job.
Therapist: If that were true, then what?
Patient: Then I would fail my family.
Therapist: And if that were true, then what?
Patient: I would be worthless.
Here you see the deeper source of the patient’s anxiety. It isn’t just about failing an exam; the student’s fear extends towards how this could impact their ability to find a job, affect their relationship with their family, and into a deep seeded belief of inherent worthlessness.
Given the simplicity of this technique, the downward arrow technique can be used outside of a therapy setting by yourself.
In this article, I discuss five benefits in using the downward arrow in your everyday life.
1. Developing greater awareness
Awareness is the first step to change. When we don’t know why we are so stressed about an exam or a friend rejecting our invitation to go out, this can be a confusing and distressing experience. In turn you may have thoughts like “why am I being so sensitive?”, or “why do I have to be so stressed?”. These thoughts naturally generate even more feelings of negativity.
The downward arrow technique gives us a more accurate sense of what this situation means to us. It gives clarity to the underlying fear and beliefs that are truly associated with our distress. For example, a fear of rejection may be tied to a deep underlying fear that a person is inherently unlovable.
2. Uncovering core beliefs and identities
Outside of the general beliefs and fears, downward arrow techniques help to identify the core aspects of the self that is associated with the more superficial issues.
Typically, these beliefs fall into feelings of worthlessness, unlovability, or ineffectiveness. As we go through the downward arrow, we may see that many issues in our lives come down to a general concept of feeling worthless, for example. We begin to develop an understanding of the reasons why certain patterns in our life come about regularly.
The question is what do we do next? Sure, awareness is important. However, how do we begin to change these fears and beliefs?
3. To identify cognitive errors
We are all prone to certain thinking errors or distortions, especially during times of distress. Through the downward arrow technique, we can decide whether or not some of the thoughts are a result of certain thinking errors. Thinking errors are ways that our brain interprets certain situations in a slightly unrealistic and negative light.
For example, the idea of failing out of school because the students failed an exam. Might that be a bit of catastrophizing? Or the idea that a friend does not value you because they rejected a hangout. There could be some mind reading going on. Here’s a post on some other types of common thinking errors.
Once we have identified some of our faulty thinking patterns, we can target them through cognitive behavioural strategies.
4. To change these beliefs or demonstrate our ability to cope
Once we have clarified our thinking patterns, we can take action to decide 1) whether these thoughts are indeed true and 2) whether we can cope with the worst-case scenario.
For example, we can use thought records or behavioural experiments to test the idea whether or not a friend truly does not think we are worthwhile. Is there any evidence for the thought or against the thought? Through this process, we come up with a more balanced thought to replace a cognitive distortion.
To test our ability to cope, you might also consider what would happen if the fear came true and how you might solve the problem. For example, if you did fail an exam, what might you do to ensure that you do not fail out of school? You might find that past the anxiety you are more resilient than you think.
5. Generally becoming more reflective
When we have negative thoughts or feelings, what is truly going on? What is happening in our mind and in our body? Why do we feel a certain way from something that seems so insignificant and small?
Through engaging in this process, we become more attuned to our own selves and more reflective in our daily behaviours. We come to understand what is driving our anxieties and where we tend to go when our anxieties creep up. As a result, we become better observers of our own world and more reflective in our approach. This can be very helpful in cultivating awareness and figuring out strategies to tackle challenges that come our way.
Best wishes,
P
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Optimizing Your Sleep: Six Components Of The Sleep Health Framework
The Sleep Health Framework (Buysse, 2014) helps us to understand sleep health in a multidimensional way, in which the sleep-wake cycle is broken into six important components that together optimizes our health and functioning.
These sleep components include:
- Sleep Regularity
- Sleep Satisfaction
- Daytime Alertness
- Sleep Timing
- Sleep Efficiency
- Sleep Duration
In this post, I discuss each of these components in turn and provide strategies to optimize these areas to improve your sleep and overall wellbeing.
Sleep Regularity
Sleep regularity means keeping to a consistent rise and wake time. Regularity in our schedule is very important to keeping our circadian rhythm attuned to the clock on the wall. This is helpful for hormone regulation and keeps the signal strong in terms of when we feel alert and when we should feel sleepy (as well as other functions, like hunger). When our internal clock is out of sync, we tend to feel symptoms similar to jetlag.
When we have a strong signal, our body naturally feels sleepy and more alert at appropriate times which helps support proper sleep health and functioning.
To support strong regularity, we should do our best to keep to a consistent bed and rise time using an alarm if needed. Beyond the nighttime, regular routine (such as when we eat and exercise) and getting exposure to light can be helpful to strengthen our circadian clock.
Sleep Satisfaction
Everyone sleeps, but many people are not happy with the quality of their sleep. The lack of satisfaction in sleep can be a result of a couple reasons.
First, people may not be producing enough deep (slow wave) sleep. Deep sleep is what is needed to produce the consolidated sleep that we find refreshing and it is built through developing our ‘appetite for sleep’. This appetite increases the longer we stay awake and active throughout the day. On the other hand, staying relatively inactive (e.g., sitting on the couch) and spending extra time in the bed awake can affect our drive for deep sleep.
A second explanation for the lack of satisfaction is that some individuals, especially those with insomnia, sometimes have unhelpful beliefs about sleep. They may incorrectly believe that people should fall asleep the moment their head hits the pillow (they shouldn’t), stay asleep the whole night (they won’t), and wake up feeling rested after 8 hours (which is unlikely).
In fact, even good sleepers can take up to 30 minutes on average to fall asleep, wake up a couple times throughout the night, and feel a little groggy when they wake up in the morning. To learn more, here’s a helpful post on common sleep norms.
Sleep Timing
Sleep timing refers to when we prefer to go to bed at night. Some of us are early birds and others are more evening owls.
Finding out your own ideal sleep window of when we prefer to go to bed and wake up is like finding the right shoe size. It fits well and feels comfortable.
For some people, they may notice that their window is not great fit for their lives and routine. For, example people with Delayed Sleep Phase Disorder might prefer to sleep very late and wake up later in the morning/afternoon. In this case, this might not be a good match for their job or responsibilities. In this case, light therapy can be a helpful strategy to shift our bedtime closer to a more socially normed period.
Daytime functioning and sleepiness
People are often most concerned about how their poor sleep affects their day ahead. They may worry that they won’t be able to focus on important work tasks, lack concentration, or feel excessively sleepy.
Getting consistent and adequate sleep is important to improve our daytime functioning. However, it is not the only answer. There can be many reasons why we are lacking in energy throughout the day: dehydration, inactivity, caffeine rebound, poor diet, hormonal issues, underlying medical conditions, among many more. To support your energy levels, consider areas in your life that may be affecting energy levels and experiment with tackling these issues.
To feel better in the morning, here’s a post on how to reduce sleep inertia.
Sleep Efficiency
Sleep efficiency is the proportion of time we spend sleeping compared to how much time we spend in bed. For example, if a person sleeps for a total of 5 hours but spend 10 hours in bed, their sleep efficiency is 50%.
Typically, you should aim for a sleep efficiency between 85 to 90%. If your sleep efficiency is too low, this can affect how consolidated our sleep is (i.e., you might toss and turn in bed) and makes the sleep much less refreshing.
Sleep efficiency can be supported by using our bed only for sleeping (to establish an association between sleep and bed in our brain) and getting out of the bed if we are not sleepy. Over time, this creates a strong signal that our bed is a place for sleeping and our body naturally prepares itself for sleep when you enter the bedroom environment.
Sleep Duration
When we do not get the hours of sleep our body needs, we feel sleep deprived. This may increase our risk of accidents, be harmful to our health, and lead to excessive sleepiness during the day.
However, the right number of hours differs from person to person – not everyone needs 8 hours of sleep (some need more, some need less). Determining this magic number for you and giving yourself a consistent opportunity to reach this target can be immensely helpful for improving your sleep.
Best wishes,
P
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Examples Of SMART Goals For Sleep
Sleep is arguably one of the most important parts of our life. When we sleep well, we feel much happier and more effective in our day-to-day life. Work comes easier, conversations flow smoother, and things are just a bit brighter.
It comes as no surprise then that improved sleep is a goal for many people. However, goals for better sleep are often quite vague, such as “I want to sleep better and feel better”.
This is a great goal but it is not specific nor necessarily actionable. Many of us have a sense of what better sleep might look like; however, this may not always be realistic or actually lead to better sleep.
SMART Goals (Specific, Measurable, Actionable, Relevant, Time Bound) offer us a way to capture what sleeping better and feeling better actually looks like during the day and night. That is, what behaviours lead to more restful and consolidated sleep.
However, before we discuss SMART goals for sleep, we need to understand typical sleep norms and tackle sleep myths to develop a healthy attitude towards sleep.
Norms and myths for sleep patterns
Falling asleep – Good sleepers typically fall asleep between 10 to 30 minutes on average throughout the week. Contrary to popular opinion, falling asleep immediately is not necessarily a good thing; in fact, this can be a sign of excessive sleepiness which could be related to sleep deprivation or an underlying medical condition (e.g., sleep apnea).
Staying asleep – People can wake up multiple times throughout the night. These awakenings usually last for a few brief moments (e.g., going to the bathroom and getting back asleep) or you may not even remember them. All that to say, these awakenings are definitely normal and not a concern unless you are up for a significant period (e.g., more than 20 to 30 minutes).
Number of hours – The 8-hour myth is just that – a myth. Most adults need between 7 to 8 hours of sleep, but the actual optimal number of sleep a person needs is unique to the individual. This is also true of the person’s preference of going to bed and waking up – some people are early birds and others are more night owls.
Stress and sleep – When we are stressed because of an exam, work, relationships – or something else – sleep naturally takes a dip. This does not mean that our sleep systems are broken or there is something wrong; people naturally have a day here and there where sleep is not ideal – and that’s okay. It is only when sleep problems are maintained over longer periods of time that we should be concerned.
Energy – Many people believe that sleeping better means immediately feeling better when we wake up and throughout the day. However, even after a great night’s sleep, we can still feel a little groggy in the morning because of sleep inertia. Another reason for fatigue during the day is that better sleep is only one part of how we feel. Other factors, such as activity, light exposure, and stress, can also play a role.
SMART Goals for Sleep
Below are a few examples of SMART goals for sleep based on these norms:
1. Falling asleep on average between 10 to 30 minutes
2. Staying asleep with a couple awakenings lasting no more than 20 to 30 minutes on average
3. Keeping to a consistent number of hours and sleep schedule that follows the body’s unique rhythm
4. Get out of bed within 5 minutes of waking up for the final time (and engaging in behaviours to break out of sleep inertia)
Using values to support our goals
Although these goals sound great in theory, they may not be perfectly aligned with your life and values. For example, there may be nights you need to stay up late to finish up some work or spend some extra time with friends/loved ones. There may also be times where you want to take an extra 30 minutes or an hour to just snuggle in bed because it’s a cozy Sunday.
And that’s completely okay! Sleep is important, but it doesn’t always have to be the number one priority in our lives. Never let perfect get in the way of good, and never let sleep get in the way of living.
Based on the norms and goal examples provided above, you can tailor these goals to match well with your life and schedule.
To support these goals, here is a post on how we can leverage our sleep system to support deep and refreshing sleep.
If interested, I have also published a book on treating insomnia and improving sleep health using science-backed strategies! You can find it here by clicking on the link: The Insomnia Paradox.
Best wishes,
P
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Getting Over Your Fear Of Being Awake At Night
People with sleep problems, such as an insomnia, tend to be particularly afraid of being awake in the middle of the night.
Specifically, they find this situation to be quite dangerous and they are filled with thoughts about the implications:
- “I’m going to be awake all night”
- “I’m never falling back asleep”
- “Tomorrow is going to be terrible”
- “This can’t be good for my health”
Unfortunately, these thoughts tend to ramp up our anxiety and make sleep even less likely to come. Moreover, people who find themselves awake might spend the night in distress, worrying about the fact that they cannot sleep. These negative thoughts can lead to a negative association between the bed and being awake.
All in all, a fear of nighttime wakefulness can be a key problem that leads to insomnia.
Why we should get over our fear of being awake at night
In clinical practice, big symptom relief in insomnia is found in an experiential shift in how we see the night. When we see it as a place of fear, insomnia persists. When the same person begins to see the night as something more benign, our insomnia symptoms begin to dissipate. This is a key concept in paradoxical intention, which is an evidence-based therapy where a person tries to stay awake (as opposed to trying to sleep – hence, paradoxically) for as long as possible.
In this post, I discuss some strategies to change the perspective of a wakeful night from disastrous to something a tad more enjoyable.
1. Understanding the sleep systems
One way to alleviate our fears when it comes to being awake in the middle of the night is to understand how our sleep systems work.
This is especially true for the sleep drive. The sleep drive is our propensity to fall asleep at any given moment and builds up the longer we remain active and awake. When we sleep, we expend our sleep drive to produce the deep sleep that we need.
For people with insomnia, they often have high anxiety about their sleep, which runs opposite to their sleep drive. Moreover, they may engage in behaviours that make it hard to build sleep drive, such as lying in bed for long periods of time, cancelling plans, and getting sleep whenever they can.
One way to reframe from the fear of being awake is that we’re actually doing our sleep drive a favour when we get up and engage in something pleasant. We are building sleep drive for the next night. As long as we stay the course (and not nap or rest all day), the next night will be better.
2. See the awakenings at night as an opportunity
During the day, we are often drowning in commitments: to our job, our partners, our friends, our family, and other obligations.
For some, it can be helpful to reframe the nighttime as a time to spend with oneself rather than a time of despair. For example, being able to finally watch that show or movie you never get a chance to see; or read a book that is usually sitting on your shelf. Regardless, to treat this as a time for yourself as a nice and peaceful night can help reduce distress. Ironically, this acceptance and embracing of the night may actually let you fall back asleep quicker!
3. Challenge the scary thoughts
Oftentimes, the reason why someone is afraid of being awake in the middle of the night is because of a strong underlying belief or scary thought.
- “What if I never fall asleep?”
- “I won’t be able to function.”
- “My health is going to deteriorate.”
In these cases, it is often helpful to directly challenge some of those thoughts. For example, is it really true that you cannot function at all if you don’t sleep – or is it just harder? Will you really never fall asleep? Would one poor night truly destroy your health?
Often times, we are able to still get the most important tasks done in a day – though they may feel more uncomfortable and effortful in insomnia. As discussed before, we are also continually building sleep drive the more active we are, so at some point the sleep we desire will come (and we are simply getting out of the way of these processes).
By taking a moment to evaluate these thoughts, we might come to the conclusion that perhaps our thoughts are a bit excessive and we can come across a more balanced thought. Thought records can be a helpful tool to evaluate these thoughts.
4. Change our relationship to our thoughts and emotions
Besides changing our thoughts and emotions directly, we can also change our relationship with these experiences through regular mindfulness practice.
Mindfulness teaches out to become more present and aware of our inner and outer experience, but in a non-judgmental manner. We learn to attend to thoughts, emotions, and sensations objectively and then let them go.
Conclusions
When we really think about it, there may not be as big of a difference being awake in the day compared to being awake at night. We place a lot of significance in being awake at night, but perhaps that’s more of a subjective perception rather than an objective problem. Perhaps it can even be fun to use this an opportunity for an impromptu enjoyable (though relaxing) nighttime activity and simply let sleep take you away when your ready to hear its lullaby.
If the nighttime still elicits a bit of a fear response, hopefully some of these strategies can be helpful to change your nighttime experience. I have also written a book on treating insomnia using science-backed strategies if you’d like to learn more!
Best wishes,
P
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Benefits Of Using Socratic Questioning In Therapy
Socratic questioning is a common technique that psychologists employ in therapy. The principles of Socratic questioning revolve around the idea that learning and ideas can be discovered by asking the right questions rather than simply telling the person.
Socratic questioning is particularly helpful when it comes to bringing insight into a person’s life and their values and beliefs.
Some examples of Socratic questions include:
- What makes you think…?
- What do you mean by…?
- How does this relate to…?
- What do you think is the main issue?
- What do you find most important about this situation?
These questions illuminate a person’s own beliefs and thoughts and help both the therapist and the patient better understand what is going on in the patient’s mind.
Other important concepts that Socratic questioning can identify from a patient include:
- Wishes, values, hopes, fears, needs
- Core beliefs
- Reasoning and thought process
- Barriers and facilitators to change
In this post, I discuss benefits of the Socratic method in therapy work with patients.
Fostering long-lasting meaningful change
When we are told how we should feel or why we think a certain way, we are likely to resist. Think about the last time your parents told you something; you probably weren’t very keen to listen even if wasn’t outright terrible advice.
However, when a person is guided to their own discovery, they can take much greater ownership of the insights. This is when the insight can really stick.
Therefore, one benefit of Socratic questioning is that the answers ring much truer when a patient comes to the answer themselves compared to the therapist or somebody else telling them. This can be helpful in engendering lasting change and be a motivator for changing our behaviours.
Understanding the patient’s unique perspective
Socratic questioning also helps to identify the patient’s unique thought process and specific values. We as therapists can come up with hypotheses on why a person feels a certain way, but hearing it straight from the patient tends to be more reliable and accurate.
Through Socratic questioning, the therapist gets valuable data to inform treatment and specific areas to target. For example, Socratic questioning might lead the therapist to notice a pattern that the patient begins to start distrusting people who get closer to them. In identifying this pattern, the therapist is in a better position to work through the patient’s challenges.
Building the therapeutic relationship
Socratic questioning has the benefit of showcasing to the patient that the therapist cares because the focus is on understanding the patient’s experience.
Through this process, the patient begins to realize that they are able to share their innermost thoughts and desires without reproach. This is fertile ground for trust and collaboration to flourish.
Reinforcing self-efficacy and understanding
As we discussed, the Socratic method allows a patient to come to their own unique insight and understanding.
This can feel very empowering and strengthen the patient’s belief in working through their own problems. They may feel less stuck in their ways and become more flexible in reflecting on their experience.
If you are interested in learning more, here’s a post on how to use Socratic questioning in therapy.
Best wishes,
P
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How To Stop Procrastinating When You Are Anxious
Many people, students and workers alike, struggle with procrastination. They may leave tasks or homework until the last minute or have to extend their deadlines. They might also spent a lot of time excessively worrying about the amount of work they have to do instead of actually doing them.
Some people struggle with maintaining their work for a long period of time whereas others struggle with getting started. They may picture the large mountain of work ahead of them, feel overwhelmed, and decide to watch a show on Netflix or scroll on Instagram.
Regardless of the difficulty, challenges in completing work can often stem from anxiety because of impending deadlines, all the other work that needs to be done, or general life stressors and concerns. Therefore, it’s important to learn strategies that help to reduce chronic issues with procrastination.
This post provides some strategies that might be helpful to getting out of unhelpful patterns and getting your work done!
Identify the specific problem
Before engaging in strategies, it is first important to identify what your issue is to begin with. For example, is it starting work? Keeping a steady flow of work going? Organizing your time to complete a task? Perhaps it’s a little bit of everything.
Afterwards, consider what might be the reason this is difficult to you. Some examples include:
- Unhelpful thoughts (e.g., “there’s way too much”, “I’ll never get it all done”, “I won’t do a good job”)
- Lack of resources from feeling stressed all the time; feeling overwhelmed
- Not seeing an end to the work (there’s always something else)
- The work is uninteresting and doesn’t feel meaningful
- Constant distractions from other things in the environment
Becoming aware of the barriers is the first step to resolving them.
Below are several strategies that you can employ to tackle your procrastination and anxiety.
Break the work into smaller steps
Getting started is sometimes the hardest step. Sometimes, we psyche ourselves out and make it even harder by thinking about all the steps we need to do to complete a project. As a result, we avoid the whole thing and engage in something more pleasant.
A good saying to tackle this issue is: “if the first step causes us to avoid, then the first step is too big”.
Break the work into smaller chunks until it feels right for you. For example, your task might be to read and make notes on a chapter for school. Instead of thinking of completing the whole chapter, start by saying to yourself “I’ll just work on one page” or even “I’ll just get started on the first paragraph”.
Once we get started, we may find that the momentum turns into further motivation to continue your work.
Build momentum by completing smaller projects
If you are feeling very motivated, then it is certainly encouraged to work on the most important tasks for the day.
However, if you’re having a bit of trouble getting started, another way to build some momentum is to complete a few smaller tasks (e.g., responding to an email, making an appointment). Completing these tasks can give a small dose of dopamine and provide feelings of satisfaction and productivity, especially if you have a list of tasks that you can cross out once completed.
Organize your time using a planner
Another strategy that can be helpful to strengthen time management and planning skills is to use a planner. “If it isn’t in the planner, it doesn’t exist” can be a good saying to remember how to track the work that needs to be done and ensure that you have a specific time you have allotted to complete the task.
You might want to start small in case the number of tasks feel overwhelming, which can make people decide that a planner doesn’t work well for them.
Visualize the future / provide yourself rewards
For some people, their current work doesn’t get done because they can only think about the next thing they have to do. This causes them to feel less motivated because there’s no light at the end of the tunnel.
Therefore, it can be helpful to do some visualization work and make some rewards for yourself once you completed the task. For example, you might think more short-term (e.g., “I will rewards myself with an episode of my favorite show once I am finished”) or long-term (e.g., “thinking about the summer vacation you will be taking or your future career”). By having something to look forward to, we may be able to break out of feelings of hopelessness.
Tackle unhelpful thoughts
As discussed, there are many unhelpful thoughts that can get in the way of getting started. These thoughts might be “if it isn’t perfect, then I will have failed” and “I am going to do poorly”.
Therefore, it’s important to identify these thoughts and challenge them. For example, you might consider alternative thoughts, such as “never let perfect get in the way of good”. Another strategy is to identify that these thoughts are generally unhelpful – not working on something because you’re worried it won’t be good might lead to a self-fulfilling prophecy.
The use of thought records can be a useful evidence-based strategy to challenge unhelpful thoughts.
Nourish yourself
When we are constantly stressed and overworked, we can feel depleted in our day to day life. This impacts our motivation and productivity.
Consider activities in your life that nourishes and depletes you. For example, nourishing activities might be spending time with friends, keeping healthy, and engaging in leisure activities. On the other hand, working, drinking alcohol, or spending time with people you don’t like could be depleting activities.
Here’s a helpful post on a few ways that you can try out to nourish yourself.
Reduce distractions and poor associations
Sometimes, certain contexts can make engaging in consistent high quality work more challenging. For example, working in your room may be difficult because you have access to games. Moreover, because time spent in your room might usually be associate with relaxing, gaming or sleeping, our brain may have made a connection that makes work even harder.
In these cases, it can be helpful to identify a place that is more likely to be associated with work and contain minimal distractions. For example, a library or café can be great places to keep yourself on track.
Best wishes,
P
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Different Ways To Practice Mindfulness In Everyday Life
What does Mindfulness practice look like?
When people think about mindfulness practice, they often have an image of a person sitting cross-legged, eyes closed, hands on their lap, and breathing in and out slowly for a long period of time.
In reality, mindfulness can be practiced in a number of different ways. Ultimately, the goal of mindfulness practice is to get ourselves out of automatic pilot (i.e., being on auto-pilot) and being more present and responsive to what’s happening around us.
What is mindfulness?
Mindfulness can be defined as “awareness in the present moment without judgment”.
People often think of mindfulness as a way to relax. Whenever they notice that the mindfulness experience is not pleasant – they are bored, irritated, or notice negative thoughts and feelings – they decide that it is not working for them, or they are not doing mindfulness right.
However, mindfulness is different from relaxation. Mindfulness is not the same as relaxation. Instead, mindfulness is about being able to observe our internal experience and being able to accept and let them go. By doing so, we take away the power of these experiences and are better able to respond, rather than react to our environment. This is the mindfulness superpower!
Below, I discuss different ways to engage in mindfulness practice to expand your possibilities for regular practice.
Mindfulness Meditation
To start, the most obvious type of mindfulness practice is meditation. This usually involves sitting on a chair on the ground and spending some time simply noticing our internal and external experience.
There are many types of mindfulness meditations (e.g., breathing space, using our 5 senses, mountain meditation) that you can choose from. The length and specific focus can be up to you in terms of what feels like a good fit for your needs.
For some, a few minutes in the morning works well; others might make engaging mindfulness meditation easier through doing a guided meditation even enjoyable places, like the shower!
Mindfulness practices with an object
Another strategy to mindfulness meditation is to pick an object (e.g., a stone or a raisin) and simply observe its qualities. You might pick out its qualities – how it feels to touch, how it looks, how it tastes – and simply notice as many aspects of it as possible. You might notice its grooves and edges, the colour, or its temperature, for example. Taking a few minutes to really notice an object and see it in a different light can be a great way to stay mindful.
Mindfulness while walking
When we are walking or driving somewhere, we are often in automatic pilot. We are so focused on where we need to be that we lose sight of the present moment. Sometimes, we surprise ourselves with that we’re already at our destination without even realizing it!
Therefore, mindful walking (or driving) can be a great way to get out of autopilot and stay in the present moment. You might notice the scenery around you, the steps you are taking, the sounds that are present.
Mindfulness and yoga
Yoga is another activity that can be a great way to engage in mindfully. Moreover, one additional benefit of mindful yoga is that it allows you to better connect with your body and its physical sensations.
This practice can be particularly helpful for people who might feel more disconnected from their body, such as those who have experienced trauma (Taylor et al., 2020).
Mindfulness of daily activities
Outside of those discussed above, many activities can be engaged in a mindful manner. For example:
- Cooking
- Reading
- Taking a shower
- Painting
- Playing an instrument
- Whatever else you can think of
As long as we are engaging in these activities non-judgmentally and one-mindfully (focusing just on the activity), these can all act as great mindfulness practice.
Barriers to mindfulness practice
Barriers to mindfulness practice can exist in many forms: we may be bored, tired, feel a resistance to negative thoughts and sensations resulting from mindfulness, or feel like we don’t have the time.
As I discussed before, try your best to incorporate these negative feelings into your practice recognizing that being able to sit with these negative emotions without judgement is one of the biggest strengths developed through mindfulness. Try noticing what these emotions feel like in the body, what our thoughts are, and how our attending to these experiences might change them.
You can also work through barriers of not wanting to engage in mindfulness practice by choosing any of the ones above that best resonate with you.
If interested, here’s a post on other ways to improve the mindfulness experience!
Best wishes,
P
Simply mental health 