Cognitive Behaviour Therapy, 2 ed.

Chapter 8. Taking Action and Responsibility

So far, most of the work has been cognitive, but there comes a point when you need to take action. For example, it is impossible to get fit by sitting at home imagining yourself in the gym. You need to start going to the gym, not just once or twice but regularly. Maintaining a momentum of action is vital. Or, if you want to have a lovely garden, you need to go out and start doing the dirty work, not just once and only when the weather is good, but regularly. After your garden blooms, you need to maintain it or the weeds will grow back. For maximum effectiveness, what you need to do is to take action and maintain the momentum after you have reflected, challenged and changed your beliefs and thoughts.

In this chapter you will learn about creating actions that enable you to achieve your goals. You will learn about reviewing your progress and learning from mistakes and failures so that you can develop and grow as a person while remaining focused on your goal. In this way, you will continue to add to your tool kit as you move on, and experience how mistakes and failures really do become opportunities to do better next time. It's natural to feel upset at first, but as long as your beliefs remain healthy and rational you can add what you have learned to your resources and try again with more knowledge and skills.

Accountability and Action

You might associate accountability with problems and blame, usually with negative connotations. Accountability really means taking responsibility without blame. Responsibility means understanding what is down to you, making a judgement about what you did or didn't do but without judging your worth. Blame, on the other hand, involves making a judgement about your worth as a human being, which is unhelpful in terms of personal development and growth or goal achievement. You already know that self-damning provokes depression, anxiety, unhealthy anger, guilt and hurt, none of which help you to think in a healthy and constructive way.

Accountability means taking responsibility for your goals, and realizing that you are choosing to have these goals and owning them. You also own the actions you are prepared to take in making them happen. Essentially, ‘if it's to be, then it's up to me’. When you take responsibility and make yourself accountable for your goals and actions, you can assess how well you are doing and learn from the experience. If you give the responsibility to someone else, you become dependent instead of being free. Accountability gives you the freedom to do what you are choosing to do.

You may say that not everything is in your control, and you would be right; however, what you do and feel about it when something is outside your control – whether you tolerate the situation or take action – is up to you. For example, if a friend lets you down a lot, then your friend is responsible for their behaviour, but you are responsible for continuing to feel let down. Making yourself accountable will allow you to truly understand the role you play in what happens in your life and what you can achieve.

Taking action is an important part of accountability. You have worked on your goals and now it's time to do something about them. If you do not take action then you are not taking responsibility for making your goals happen.

Two forms comparing options 1 and 2 by listing advantages (top) and disadvantages (bottom). summarizing the processes on changing beliefs from educating oneself about CBT philosophy down to using mind and plan and imagining change with an addition of taking action now.

You have worked on setting goals and on changing your beliefs. Because you set a SMART goal you also have a target date for achieving it. Now it is time to take action. This involves planning and knowing the activities you will need to do in order to make your goal happen. The preceding flowchart summarizes the process so far with the addition of taking action.

When you think about your goals you might realize that they can be broken down into the three areas listed below. Whatever area they come into, the above process still applies:

1. To develop your ability and performance

These goals are about gaining knowledge and understanding and then moving on through experience to become more competent. Initially you would want to increase your knowledge about, raise your awareness of or know how something works. You may also want to be able to explain to other people how the something works. As you gain experience your goals may change to include being more able and more effective.

2. To enhance your knowledge and skills

These goals involve building on your competence and skills. They are about becoming very good, or excellent, or even the best there is. So if your goals fit into this criteria you would be looking at using your skills and competence in more complex ways, for example becoming a specialist. These goals are about enhancing your skills or expertise.

3. To get involved in something new and challenging

These goals are concerned with getting involved in challenging new situations, tasks or ventures, and then developing your skills so you can succeed in them. These types of goals may involve retraining or gaining new experiences.

The actions you now take should fit in with your goals and the areas your goals fall into. There are many types of different actions you can take. The following guidelines are just some examples that can apply to work or to non-work-related goals.

Doing new and different things

1.     Look for new opportunities in what you are already doing, so that you can learn and develop. For example, if you are looking to develop within your present job, you could do new things and expand your existing role by talking to your manager.

Short-term role changes

1.     Rotate with another person to enhance your skills, stand in for a colleague, or get seconded to another team within your area of work.

Shadowing

1.     Watch and learn from a colleague or more experienced person. Shadowing is part of the training process in many industries, such as teaching or the airline business.

Coaching or supervision

1.     Get one-to-one support from an expert to learn and improve existing skills. In the business world this is commonly referred to as coaching. In psychological services it is often referred to as supervision or clinical supervision but the objective is the same.

Distance learning

1.     If at the moment your time is limited by your 9-to-5 working day, learn something new at your own pace. There are many courses that can help you to enhance your current knowledge or learn something completely new, for example IT skills. You can also find information on your specific interest in books, journals and on the internet.

Personal development

1.     As you strive towards your goals, you may become aware of deeper rooted psychological challenges that require more than self-help books, which may mean finding an experienced therapist. Remember it is important that you choose the right type of therapy so the best thing would be to seek a medical or psychiatric referral or word-of-mouth recommendation.

Networking

1.     If you are keen on developing your professional life or work goals, you could seek to build both internal and external contacts. Outside your work environment you can probably find many groups that meet regularly and exchange business information within an informal setting.

Challenging tasks

1.     The most effective way to expand your comfort zone is to commit yourself to doing something challenging. If, for example, you have been working on performance anxiety problems, such as talking in front of an audience, then after you have done your cognitive preparation, volunteer to do the next presentation at work or make a sales pitch, or introduce yourself to new colleagues. Or you might commit yourself to a deadline or a new project and start it today.

Immediate tasks

1.     Think about what you can do right now in order to kick-start action. For example, writing a letter, making a phone call or filling in the application form that has been waiting on your desk for the last month.

Additional training or workshops

1.     If you want to find information about something that is of interest to you, you can find out if there are taster courses or, if you want to further enhance your skills, you can start attending workshops. In almost everything that you want to do, you will find that you can always develop your skills further.

Further qualifications

1.     If you are interested in changing direction or simply wishing to further your professional or academic qualifications, there are many routes open to you.

Other interests

1.     This is a catch-all area for your external interests, for example charity work, clubs or groups for professional reasons, sport and leisure.

Free advice

1.     Government and private agencies offer free advice in many areas. For example, many banks provide leaflets on writing a business plan and offer advice and guidance on starting a new business.

Exercise

Now that you have worked on your beliefs and feel that you are ready to expand your comfort zone by taking action, think of the actions that you can take today.

Write your SMART goal.

Write the overall target date for achieving your goal. Write down your healthy beliefs.

Make a list of the immediate actions you can take. Do not wait for tomorrow or next week.

Write down all your action ideas to enable you to achieve your goal.

For example:

·        Talk to my family about what I want to do.

·        Get relevant information about the course I'm interested in.

·        Ring the bank to make an appointment to discuss a loan.

Be Open and Learn from Failures and Disappointment

When you start taking action towards achieving your goal, and after you have started strengthening your healthy beliefs and weakening your unhealthy beliefs, you will feel a mixture of tension and excitement.

You will feel tension because you may be stretching your comfort zone – which is good – and excitement because you are doing something positive by taking action.

Most of the things you have done so far have involved learning and being open-minded. When you started reading this book, you learned about some aspects of CBT. As you continued you learned more specific ideas and how to use your cognitive skills. Some of the concepts may have been thought-provoking or challenging at first, but you kept an open mind and continued learning. You will now need these two specific resources as you start taking action – being open-minded and learning from your experiences.

Being open-minded is an excellent trait to develop because it allows you to remain receptive to new opportunities and possibilities – and that means more resources to achieve your goal. However, if you stick to one way of doing things even when you have the chance to learn about other options, then you limit your ability to achieve your goal. So stay open-minded because usually there are much better and more effective options.

Remember the diagram below? If you believe that you have nothing further to learn then you become closed and unconsciously incompetent, and you stop looking for new ideas and ways to learn and improve.

Cycle diagram from 1 Consciously incompetent to 2 Consciously competent (top) to 3 Unconsciously competent to 4 Unconsciously incompetent (bottom) with a horizontal line in the middle.

When you start to take action, bear in mind the fact that you are stretching your comfort zone. Looking at the above diagram, remember you may be starting from point 1, so the likelihood of disappointment and failure is quite high. You will become more experienced and more successful if you stay open-minded and learn from your experiences.

The diagram below illustrates the learning process.

Diagram of the learning process with “What did I want to achieve?” atop leading to a cycle from “What did I achieve?” to “Reflect on the experience” to “What can I learn?” to “What would I do differently next time”.

Example

Tom wants to make a smooth and confident presentation to his colleagues at work. He has been working on changing his anxiety-provoking beliefs regarding presentation and has now volunteered to do the next team presentation as part of his action-taking plan. His presentation is on improving customer services.

After his presentation Tom applies the learning process by asking the following questions:

What did I want to achieve?

I wanted to achieve a smooth and confident presentation.

What did I achieve?

I achieved a presentation which was good. It was not as smooth and confident as I would have liked. I didn't get the kind of response I wanted regarding my suggestions on improving customer services. My manager said ‘well done’.

Reflect on the experience

The experience was good because I knew I was out of my comfort zone. I am just starting to do presentations so it is understandable that I have lots to learn. I am happy that my manager said ‘well done’. I felt uncomfortable at the beginning but then I relaxed. After the presentation was over, I did worry about it a little.

I did not invite a discussion on my suggestions for improving customer services and I did not ask for feedback about my presentation.

What can I learn?

I know that I can now stand in front of people and present. It will take time to be confident because I'm just starting. My discomfort was natural and understandable because I am continuing to strengthen my healthy beliefs and weaken my unhealthy beliefs.

I can be more interactive when I'm presenting and invite people to contribute. This would make it more interesting.

What would I do differently next time?

I will volunteer again and next time I will ask questions and invite people to discuss any ideas I present.

I will also ask my manager to give me feedback on what I can improve in the presentation.

I will ensure that I counteract any feelings of worry by reciting my healthy belief and ensuring that my thoughts and self-talk remain constructive.

I will continue to use the imagery techniques to deal with negative outcomes and see myself at my best.

Exercise

Reflect on what you wanted to achieve from the actions that you have taken.

What did you achieve in reality? Be honest and realistic.

Reflect on the experiences you had when you took action and think of both the positive and the negative of the experiences.

What did you learn from your reflection? Be constructive. What would you do differently next time?

Acknowledge and Express Your Feelings Appropriately

When you start to take action you will either achieve what you wanted to achieve completely, partly or not at all. Whatever you achieve you will experience a feeling about it, and this is natural. You may experience happiness and excitement, mixed feelings or disappointment and upset. Whatever you feel, it is important to learn to express it appropriately. Striving for your goals does not mean you become an unfeeling robot, always positive and upbeat. What you are aiming for is to acknowledge and express your emotions in a healthy and appropriate way.

You read about the ABC model of emotional disturbance and how sometimes AC expressions are used. This is when you make the cause of your emotions the very experience that you have just had, or are having, or might have. AC language essentially says: ‘I'm not responsible for my emotions but he or she or it is.’

A

B

C

Event

Belief

Consequences

 

Healthy or unhealthy

Emotions

   

Behaviours

   

Thoughts

   

Symptoms

AC language is when you say or think:

·        He made me angry.

·        My job makes me depressed.

·        You upset me.

It is clear that there is no emotional responsibility in AC language. When you start to take action it is important that you learn to express your feelings appropriately for a number of reasons. Firstly, you will be feeling something, and keeping it bottled up is unhealthy. Secondly, the appropriate expression of your emotional response plays a part in strengthening or weakening your belief in your emotional responsibility and accountability. For example, if your application for a loan or a job is turned down and you tell yourself, ‘filling an application form and sending it in makes me nervous because I was turned down the last time’, what exactly are you implying? When you reflect about that expression it's easy to see there is a deeper implication. Repeating that type of expression would condition you to think unhealthily again.

How to express your emotions

Emotions can be expressed appropriately when you own them. This means thinking and talking in a responsible and empowered way. For example:

·        I feel anxious about …

·        I felt angry when …

·        I am upset about …

·        I am happy about …

·        I am excited about …

·        Avoid expressions like:

·        You make me anxious …

·        You made me angry when …

·        This makes me depressed …

It is extremely important to have good communication and to express your emotions appropriately, particularly when you are working in partnership with other people.

Certain expressions can be a trigger for a defensive response from others. Can you remember a time when, for example, someone gave you feedback about something that you did or didn't do or about your performance, and you were told ‘you made me feel anxious’, or ‘you make me angry’? It's not surprising that you may have felt defensive and perhaps equally attacking. In constructive communication, appropriate expressions would be:

·        I felt anxious when you said …

·        I felt angry when you behaved …

·        I felt sad that you were …

When the emotional response belongs firmly to you, the other person is unlikely to feel attacked or defensive and they can then respond more calmly or healthily.

When you have achieved what you wanted

When you have achieved your goal, acknowledge it positively and also recognize the help that you have been given along the way from other people. It is important that you acknowledge your achievement and pat yourself on the back for your success. This is as important as learning from your mistakes. It is good to tell yourself that you have done well and that you are proud of yourself. It is also good to acknowledge those who have supported you or have contributed to your success. Celebrate your achievements because it will feel good and reinforce and strengthen your conviction in your own ability.

If someone compliments you on your success or achievements, accept it positively. In the past you may have tended to dismiss compliments but now you can send a clear and positive signal to yourself about your own abilities by acknowledging compliments from others. Initially, you may feel awkward, but you are simply being polite and respectful to the person who is being generous enough to compliment you. Once you have accepted the compliment then internalize it.

When you have partly achieved what you wanted

When you have partly achieved what you wanted, acknowledge what you are feeling about it. You may feel a healthy negative emotion like disappointment, annoyance, regret, concern or sadness. You may also feel unhealthy negative emotions like hurt, unhealthy anger, embarrassment, anxiety or depression.

If your feelings are healthily negative, you may need a few days before you are ready to reflect objectively. Healthy negative emotions will heal and you will soon re-focus on your goal. You will know that you are experiencing healthy negative emotions because your thoughts and behaviours will still be constructive and healthy.

Once you have acknowledged your feelings, consider the things that went well and the things that didn't.

Acknowledge the things that you did well and reinforce them by being positive about them. It is important that you have a sense of balance about what has happened. Most of the time you will find that some things went well, so affirm that was the case. Learn from what did not go well and then think about what you will do differently next time. This will provide a progressive action plan that is fluid and forward moving.

If your feelings are unhealthily negative, it means you have an unhealthy belief about what has happened. You will know that your feelings are unhealthily negative because you will feel stuck and unable to move forward or to let go. Your thoughts and behaviours will not be healthy or constructive.

If your feelings are unhealthily negative, you will need to identify the unhealthy belief(s) and start by challenging it and working on its healthy version. You will then need to strengthen the healthy version and weaken the unhealthy version. Essentially you will apply the CBT process you have been learning.

Once you make the change to your beliefs then you will be able to think more objectively, as if you have healthy negative emotions.

When you have not achieved what you wanted

When you have not achieved what you wanted you may experience either a healthy negative emotion or an unhealthy negative emotion.

Once you have acknowledged your healthy negative feelings, sit down and reflect on what happened. Think about what you have learned and what you will do differently the next time.

If your feelings are unhealthily negative, you need to change the unhealthy beliefs causing them. Reflect on what happened in a constructive manner, identify what you learned and what you will do differently the next time.

Decision Making

In order for you to achieve your goals you will need to take appropriate risks. This involves decision making. The decision is either to do or not to do something. It is about staying put and not making any change, or making the decision to pursue your goals and desires. In order for you to make this decision you have to weigh up the costs and benefits of making a change or whether or not to strive for your goal.

Life is full of risk and you cannot totally eliminate it from your life. There is an element of risk in everything you do, whether it is crossing the street, getting into a car, doing a presentation, eating something or getting ill. Even if you decide to stay in bed and not do anything, life is still risky. The bottom line is that in order for you to achieve something, you will need to take risks by taking action and making a decision. Being totally risk free is unfeasible.

However, the degree of risk you are willing to take will depend on you. You may be a high risk-taker or a very cautious person. Your attitude to risk and how much risk you take will impact on the decisions you make and ultimately on what you may achieve.

Having healthy beliefs means that you are psychologically strong enough to pursue your goal and deal with the possibility of not achieving it in a constructive way so that you can re-focus on it later. So the starting point is with your attitude and belief system.

Working on strengthening your healthy beliefs will enable you to be more objective about making decisions and pursuing your goals.

1.     First you set a SMART goal.

2.     Begin to gather information about what is actually involved in the process, educating yourself, learning about concepts of psychological health and the process of change. At this stage you will really decide if it is something that you wish to invest in or not.

3.     If you decide that it is significant enough to pursue, you then begin to plan. To change your unhealthy beliefs, you start to plan by using your cognitive skills.

4.     After you plan, you then take action. This is the doing part of the behavioural change that you are undertaking.

5.     Then you assess how you did and learn from it.

Point 2 above explains appropriate risk, reflecting on your decision and then committing to your goal or an option. You can assess this dilemma more effectively if you apply a simple business technique called cost benefit analysis. As the name implies, you will be assessing the cost and benefit of either taking a risk and pursuing your desire or not, or simply deciding between two options and assessing which you feel is more desirable to you at a given point in your life.

Once you have considered the costs and the benefits you can then reflect more objectively on how you wish to proceed or which option to commit to.

The following is a simple form you can use when you wish to weigh up the pros and cons.

You can see that this form takes into account the advantages and disadvantages of not making a change, and the advantages and disadvantages of making a change or choosing the goal in both the short and in the long term. This is extremely important because often you will find that you may make a decision based on how you are feeling now. If you remember that striving and pursuing your goals will feel uncomfortable at first, it helps to focus your mind on the long term so that your decision is based on the end result and not just short-term discomfort.

Do it Again

You will have realized that throughout this book concepts are repeated in different ways. Repetition is vital, just like learning from your experiences and then doing it again.

The process of goal attainment involves focusing on your goal and overcoming hurdles along the way. These hurdles come in numerous guises but the main point is that you can overcome many of them and accept those that you cannot without letting go of your goal, as long as it stays significant for you. So, at first, if you fail, reflect on the experience, assess it objectively, learn from it and do it again with what you have learned firmly at the forefront of your mind.

To assess the reality of continuing to strive for your goal, consider the costs and benefits of it all. If the benefits outweigh the costs to you, you can do it again and again. This process of assessment should include the benefits and costs to the people in your life too, and provided you have thought about this, you can go ahead and make your choice.

When you learn from your experiences and decide to do it again, ensure that your feelings, thoughts and actions are in accordance with your healthy beliefs and attitudes. This is not being selfish or uncaring, simply accepting the consequences of your decisions in the right spirit of choice and accountability.

Option/Problem 1

Option/Problem 2

Advantages/Benefits

Advantages/Benefits

Short term

Long term

Short term

Long term

       

Option/Problem 1

Option/Problem 2

Disadvantages/Costs

Disadvantages/Costs

Short term

Long term

Short term

Long term