A Mindfulness Response: Thoughts

Thoughts

During many group sessions, participants stated they knew many skills but could not change their attitude. We learned to recognize cognitive distortions, connections to symptoms, and intense feelings. We constantly discussed poor choices and helped each other understand the process of developing helpful skills that take time and practice.

One participant was frustrated and talked to the group about knowing hundreds of skills but being so burned out that they quit their job.  They admitted to isolating, not communicating, not wanting to take medications, and having crying spells. The group identified perfectionism and “all or nothing” thinking when asked about negative thoughts.

Perfectionism is learned from childhood, and altering thinking habits takes time. They expressed problems with needing to achieve and not being good enough. The group validated the frustrations and reminded Cary that coming to the group was the first step in making a change.

I discussed withdrawing from others and the bad habits of ignoring phone calls, texts, and emails and how it affected psychosis symptoms. The group suggested that awareness of irrational and negative thoughts is key to changing the mindset. The group discussed how to do this and found ways to solve and change problems. The group included self-compassion to lower frustration by realizing that making achievements can become a trap as a habit.

One member pointed out that it didn’t matter if achievements or goals were accomplished if the final thought was, “I’m not good enough.” It was a sign of how the inner self wanted something different, and using self-kindness was necessary to make that change.

Awareness of My Thoughts: Changing My Attitude or Mindset

            I wanted to slow down this process because changing thinking patterns is hard. The staff explained what we had learned recently, and we reviewed ways to recognize this. We discussed how the brain generates thousands of thoughts, which can create PTSD flashbacks, cognitive distortions, images, sensations, intense emotions, and psychosis symptoms. We re-examined our negative thoughts or cognitive distortions and identified our usual patterns of thoughts.

The staff discussed the combination of CBT and self-compassion and how it helped participants realize that negative thoughts kept them stuck in depression, anxiety, and panic attacks. Their distressing mood worsened their psychosis symptoms. Awareness of patterns of behaviors, thoughts, and feelings helped participants realize their self-critical thoughts. The thought initiated fear of failure, rejection, abandonment, embarrassment, and other feelings. We practiced mindfulness as a group and at home, wrote down distressing symptoms, and brought them to therapy to learn this.

            The group challenged each other with perfectionistic thoughts and ideas about how learning self-compassion skills might bring about a change. One member discussed an idea that was a delusion related to psychosis with the group. The delusional thought was based on fear of rejection and that whatever was done was not good enough.

            Delusional thoughts are attached to strong feelings. Kim and Cary discussed these in group therapy and how they could not do a reality check to stop them. The group discussed how delusions can come in different varieties, and participants talked about their personal experiences. When people are paranoid, the group discusses the level of anxiety, fearfulness, hyper-vigilance, and paranoia.

            The group read notes from a journal and said the delusion was associated with perfectionism and not being good enough, so they had to constantly try to correct projects or decisions.  This created more ruminating and worrisome thoughts. One member said they had panic attacks every week and ongoing anxiety related to comparing what they did to others.

The group challenged the delusional thought by asking what symptoms were noticed, what evidence was positive for it, and what was negative against the delusions. One member had a chart, talked about it, and described getting lost in thoughts and daydreams. They said the thoughts start, imagination expands into a daydream, and nothing gets done. The member said it wasn't easy to separate reality from the daydream. The group discussed how valuable it was to understand that this could happen. The discussion included strong feelings and thoughts that can be delusional.

Thought/delusion	Positives	Negatives	Outcome or Result
A voice tells me that I am not good enough and inferior to others. It tells me to do it again and start over because it’s terrible.	I want to do things correctly. I want to do quality work. I think it’s ok to double-check things. I get praise at my job for high-quality projects.	I worry constantly. I can’t sleep well because I worry about work and now everything. I am afraid of starting new projects or small chores. I feel burned out from work and everything. I have a headache and stomach ache.	I need to stop worrying about everything. Medications have helped reduce worry and anxiety. I can practice distraction and mindfulness.