A stress test involving nearly 33,000 respondents from 172 countries uncovered evidence that rumination (worrying endlessly about past events) and self-blame (holding yourself responsible for negative events) are two of the most important predictors of mental health problems. The research, published Oct. 19, 2013 in the online journal PLoS One, found that regardless of the number and severity of negative events in their lives, respondents who ruminated or blamed themselves for their difficulties were significantly more likely to have higher levels of depression and anxiety than participants who did not engage in these behaviors.
The study, suggests not only that the way individuals think about and deal with negative events may lead to psychological problems, but also that psychological problems might be avoided or reduced by teaching individuals to approach life’s difficulties in a different way.
WHAT YOU CAN DO
Dr. Pava recommends the following reading list for people who are experiencing feelings such as guilt, self-blame, anxiety, or depression:
- The Mindful Way Workbook, John Teasdale, Mark Williams, Zindel Segal, (The Guilford Press, New York). An eight-week, step-by-step program designed to help readers learn mindfulness-based cognitive therapy strategies to deal with persistent emotional distress and depression.
- The Feeling Good Handbook, David D. Burns, MD, (Plume, New York), Techniques and step-by-step exercises designed to help readers learn cognitive therapy strategies to work on dis-tressing emotions and self-defeating attitudes.
- Mind Over Mood, Dennis Greenberger, Christine A. Padesky, (The Guilford Press, New York), A primer in cognitive therapy with step-by-step worksheets that teach specific skills for conquering de-pression, anxiety, guilt, shame, and other feelings.
“There is a theory that certain individuals may have a cogni-tive vulnerability to depression and anxiety based on their attributional style, or way of explaining the causes of events,” explains Joel Pava, PhD, Director of Psychotherapy Service at MGH’s Depression Clinical and Research Program. “These individuals may attribute the occurrence of negative events to their own personal traits, faulting themselves rather than con-sidering factors. Their default explanation when things go wrong is that they possess some negative trait that accounts for the bad outcome. These traits tend to be perceived as internal, global, and enduring. Instead of trying to analyze and solve a problem, they conclude that there’s no point to doing so since the ultimate cause of the problems is that they are, and will always be, for example, incompetent or unloveable.”
Feelings such as shame, guilt, and regret affect everyone from time to time, and they may play a healthy role in developing more positive and pro-social behavior, Dr. Pava points out. However, overfocus on these feelings may paralyze people from moving forward in positive ways.
Dr. Pava explains, “People may feel guilt and shame that is adaptive (‘I hurt someone’s feelings, and so I will apologize’), or non-adaptive (‘I hurt someone’s feelings. I can never do anything right. I cannot face that person again.’). Some of these non-adaptive negative thought patterns can be thought of as bad habits.”
Fortunately, people can learn to challenge non-adaptive thinking, in-crease perspective and move away from rumination, Dr. Pava says. He suggests trying the following strategies to help interrupt these thought patterns:
- Monitor them. Take note of how frequently you process problems using a negative explanatory style.
- Challenge them. Use cognitive strategies to review the evidence that supports your negative, self-blaming interpretation, consider other explanations, and notice how you feel when you come up with a more balanced interpretation of how a problem developed. Focus on practical solutions to a problem. This will interrupt reminative thoughts and help create a sense of well-being and optimism. Over time, these strategies will help you develop a sense of perspective about events and thoughts, questioning the validity of these thoughts, and making an attempt to break habitual thought patterns.
- Practice mindfulness. Complement more traditional cognitive-behavior strategies with mindfulness practice, which can reduce the stress associated with strong guilt, shame and self-blame. Sit quietly, breathe slowly and deeply, and experience your thoughts as they come and go. Try to accept your feelings, observe them dispassionately, and then return to concentrating on your breathing.
“Consider psychotherapy if your own attempts to deal with rumination and self-blame are not successful enough,” Dr. Pava advises. “A practitioner skilled in cognitive-behavior therapy or mindfulness-based cognitive therapy might be especially helpful.”
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