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2025年03月の記事

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『反すう焦点化認知行動療法の理解を深める』から学んでみよう

【たいせつなこと】　昔から行われてきたタイプの認知行動療法は、否定的な感情（ネガティブな感情）を扱い、それを修正することで成果を上げてきました。しかし、ネガティブな感情だけではなく、肯定的な感情（ポジティブな感情）に焦点をあてて、そこに働きかけていくことで、従来よりも更に効果の高い相乗効果を期待できます。　「反すう焦点化認知行動療法」はポジティブな感情に焦点をあてる治療法です。自分が反すうしすぎるとき、それを認め、新しい対応方法を理解したり、自ら気づいて対応していきます。練習が必要ですが、効果が期待できる方法なのです。【具体的な各情報】　反すうとは、症状（疲労感・抑うつ気分など）、感情、問題、心を乱すできごと、そして自己の否定的な側面について繰り返し生じる思考であり、原因・意味等に焦点を当てるものと定義されます。　反すうは、うつ病や不安症の発症・維持に関わる認知的プロセスです。この反すうを対象にした認知行動療法の一つが、反すう焦点化認知行動療法（RFCBT）です。反すうを直接的に介入対象とする認知行動療法（CBT）の一つです。　RFCBTは機能分析的アプローチをとります。反すう（や回避行動）の機能や生じ方を特定したうえで，反すうのプロセスをより建設的なプロセスに置き換えることを目指します。RFCBTは、うつ病の残遺症状と急性期うつ病の支援、並びにうつ病・不安症予防に対する有効性が示されています。【RFCBTの治療原理】①反復的な否定的思考（＝反すう，心配）と回避が、うつ病を持続させることを自覚・理解します。②反すう・回避は正常な反応であり、起きても仕方がない場面で、限られた時間行う分には有効です。③それらが過剰になったとき・バランスを失ったときに問題になります。④過剰になるのは，過去の経験に基づきます。過剰学習による観察学習や、過去に反すうが有効であった経験から学習されます。⑤学習された反すうは、繰り返し用いられることで習慣化します。その結果、意識しないうちに始まるようになります。この特徴を理解します。⑥反すうが学習されて身についたのと同様に、反すうとは異なる対処方法も学習可能であり，それによって反すうを置き換えることができます。⑦治療の中で，新しい適応的な対処方法を，クライエント自身の体験の中から見つけ再学習を促します。治療者は広い視点からコーチングします。⑧学習された習慣である反すうを変えるには，反すうのきっかけとなる状況・出来事に対する気づきを高め、習慣を変えるために繰り返し練習することが重要です。時間と労力がかかりますが、不可能ではありません。【RFCBTの基本原則】1. クライエントの反すう体験をノーマライズします（注目している経験を客観視して一般化します）。2. 反すうを明確な治療ターゲットとして位置づけます。 3. ACESの法則：能動的（Active），具体的（Concrete），体験的（Experiential），場面特有（Specific）的行動を増やします。※場面特有的とは、特にクライエントの反すうが頻繁に生じる場面を設定します。4. 機能分析的アプローチを実施します。※機能分析的アプローチとは、機能分析（ABC分析）のことです。弁別刺激（先行刺激）の結果、行動（反応）が生じてその結果、行動した結果が生じます。5. 行動とトリガー・危険サインをリンクさせる。※トリガー≒反すうするきっかけ。6. 反復練習の重要性をクライエントに理解してもらい、実践してもらいます。7. 適応的な思考スタイルへと変化していきます。 8. 心理療法の共通要因の重要性は変わりません。温かさ，共感，前向きさ，肯定，辛抱強さなど。　反すうと自動思考の関連について。反すう的な反応スタイルは，自分自身の感情や気分の状態に焦点をあてて、気分を紛らわせる行動をとらせないようにする行動・思考の一連のプロセスです。気分が落ちこんでいると気づいたときに、その気分に対して意識を向け、「気分が落ちこんでいる」と自覚し、それについて考えることを含みます。したがって，反すうの結果として否定的な自動思考が生じることはありますが，反すうは自分自身の感情や気分の状態に意識を向けることから始まる一連のプロセスであると言えます。　他罰的な反すう思考はあるのか？について。反すうは基本的には自分自身のある側面について繰り返す否定的な思考です。なお、怒り感情に関する反復的な思考は「怒り反すう」と定義されています。（尺度も開発されています）※怒りは他罰的な思考と併発しやすいと言えるでしょう。　RFCBTの特徴の一つとして，ポジティブ心理学的な見方に基づく介入を含む点が挙げられます。何かに没頭して、取り組んだ記憶や体験を活かして反すうから抜け出そうとするRFCBTのアプローチは、チクセントミハイによるフロー理論にも基づいており、 RFCBTの介入の重要な一部を構成しています。没頭体験に関わらず，人のポジティブな側面に注目するのは、近年のCBTの特徴の一つであるようかもしれません。　人のポジティブな側面を注目することは，ポジティブ感情の高まりと関連してネガティブ感情が低下しうることを示唆しているようです。ネガティブな感情を扱いながらも、そこだけの変容を促すのではなく、ポジティブな感情に対しても働きかけを行うことで、うつ・不安の支援の有効性がさらに高まる可能性があることを，RFCBT やPATの効果研究が示しているのかもしれません。※ネガティブな感情を扱う方法は、従来のCBTで対応してきた通りです。それにポジティブ感情にも働きかけることで、相乗効果をねらっているのです。今回は以下の論文から学ばせて頂きました。『反すう焦点化認知行動療法の理解を深める』著者：梅垣　佑介奈良女子大学心理臨床研究第11号　2024年　pp.17–25

2025.03.31

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『キャリア教育と就労支援における認知行動療法の現状と可能性』から学んでみよう

【たいせつなこと】　障害のある人が身近で生活するのが当たり前となった日本において、働くこと（就労）は障害者が社会に参加する為の大切な方法の１つです。　特に初めて社会に出て働き始める学生の障害者にとって、「働きはじめること」は大切な問題です。　国が示したキャリア教育においても、「①人間関係形成・社会形成能力」、「②自己理解・自己管理能力」、「③課題対応能力」、「④キャリアプランニング能力」が人生を生きていく上で大切であると示されました。　そして対象となる学生や障害者に対して、働けるように教えたりトレーニングすることが効果的です。そうした支援する為に重要な方法の１つが、認知行動療法なのです。【具体的な重要情報】　「障害者に関する世論調査」において、障害のある人が身近で生活しているのが当たり前だと回答した人の割合は93.9％にのぼり、わが国の障害者の権利擁護や共生社会に対する認識は広がりつつあります。　「就労」は、障害者の社会参加の促進のための重要な要因の一つです。わが国でも、障害者の職業的自立に関連する法改正等が継続的に行われています。　障害のある児童生徒の卒業後の進路決定に関する教育の必要が高まったきっかけは、1979年に養護学校教育の義務制が施行されたことでした。高等部の生徒の卒業後を見据えた職業教育の充実が重要課題とされるようになり、養護・訓練の内容の改善や職業教育の充実を図るための教科等が設置できるようになりました。　知的障害者の職場適応に対する知的能力の影響はそれほど大きくありません。知的障害者の職業的自立には、企業側の要因と本人側の要因とが、変化しながら活動的にからみあっていること（ダイナミクス）を明らかにし、知的障害者一人ひとりの職場適応像は、環境要因と個人要因との相互作用によって形成されることを示しています。　難しく言い換えると、知的障害のある児童生徒への職業教育として実施される各種の作業技能や作業工程を習得する指導において、応用行動分析学の考え方や個人と環境との相互作用という視点が生かされてきたと言えます。　障害のある児童生徒への職業教育・進路指導の動向に関するもう一つの大きなきっかけは、2011 年の中央教育審議会による「今後の学校におけるキャリア教育・職業教育の在り方について」の答申です。　キャリア教育で育むべき基礎的・汎用的能力は、「①人間関係形成・社会形成能力」、「②自己理解・自己管理能力」、「③課題対応能力」、「④キャリアプランニング能力」という4つの概念で整理されました。　それらの教育実践において、認知行動療法が有効であることが実証されており、特に、「①人間関係形成・社会形成能力」を育むアプローチとして、ソーシャルスキル・トレーニング（SST）の適用が有効であるという報告が数多くあがっています。　　特別支援学校におけるキャリア教育では、SSTやストレスマネジメントといった認知行動療法の諸技法が取り入れられ、定着しつつあるのです。　キャリア教育の重要度はさらに高まってきています。学習指導要領には、キャリア教育の実施にあたっては、児童生徒が活動を記録し蓄積する教材等として「キャリア・パスポート」を活用することが提言されています。「キャリア・パスポート」とは、学習の見通しや学習の振り返りを児童生徒自身が記録し蓄積するというものです。これは認知行動療法の技法の一つであるセルフモニタリング（自分で自分自身を観察し続けること）と似ています。　今後さらに重視されるキャリア教育においても、認知行動療法の理論や諸技法は、様々な場面で活用可能です。キャリア教育の効果的な実践を後押しすると期待できます。そのためには、キャリア教育として取り組む様々な教育活動において、認知行動療法の理論や技法が応用可能であることを多くの学校教員に伝える必要があります。　特別支援学校高等部の入学者が年々増加し、卒業後の進路として一般企業に就職する者が増えています。さらに、障害者総合支援法における就労系障害福祉サービスから企業への就職も増加しています。この就労数を押し上げているサービスの中心は、就労移行支援事業です。（2年間の利用年限の中で、通所活動により障害のある人の特性を把握し、必要な準備を整え、職場との相性を踏まえた就職を目指す支援）　現状の問題点としては第１に、移行期支援に携わる教育者や支援者には、多岐に渡りかつ地域や時代により異なる事情を持つ選択肢の中から、一人ひとりに合った選択を、適切に支えるためのアセスメント、プランニング及び意思決定の支援が求められますが。日本にはまだ制度が整っていません。　第２に、移行に伴う分断とメンタルヘルス課題が生じやすいことです。捉え方・分析の仕方・支援制度や組織の違いや変更などが原因です。　第３に学校から社会組織に移っていく移行期では、与えられた環境に馴染もうとする適応努力が過剰になる「過剰適応」が起きやすく、燃え尽きが生じる可能性も高まります。すなわち、過剰適応を助長しやすい現在の教育の枠組みの上（先ほどの「移行に伴う分断」が生じるため）に、成人医療への移行の難しさが重なると、職業場面での過剰適応の状態や燃え尽きの兆候に気づきにくくなり、適切な見立てと対処が取れずにメンタルヘルスを増悪させてしまう恐れがあるのです。　2023年改正の障害者雇用促進法で、「職業能力の開発及び向上に関する措置」が事業主の責務であるとして明確化されました。過剰適応の問題は、就労上のメンタルヘルスに関わる一層重要な課題となることが予想されるので、今後注意していく必要があるでしょう。　合理的配慮は、障害者手帳所持者に限らず、自己申告に基づきすべての障害のある人に申請が可能です。社会的なバリアを無くしてほしいと要望があったときに、無理なく合理的に対応される配慮です。「ナチュラルサポート（同じ職場の上司や同僚からサポートを得ること）」の形成などを目指します。職場環境における「正の強化」で維持される行動を拡大させる手続きとも言えます。　合理的配慮とは、個別的かつ具体的な調整を実現するために、「行動」を「環境との相互作用」の結果としてとらえることができます。その為、認知行動療法の視点が有用です。　「多様な心と脳が存在する」という現実を指す用語ニューロダイバーシティ・アプローチにおいて、障害は、個人の特性と周囲の環境との相互作用により生じるものであると捉えます。　国内における障害者雇用における職場定着の現状を確認すると、障害を開示した求人であることがより職場定着を高めていることや（1年で70.4％）、精神障害のある人の職場定着率が1年で49.3％に留まっていることなどが報告されています。これらの数値は決して高いとは言えず、解消の為にジョブコーチ理論に基づく職場適応援助者による支援制度や就労定着支援事業が設けられています。　職場定着に関する支援において、認知行動療法はどのように役立つのでしょうか？　職場定着支援における介入方針は主４つあるとされています。①住環境について話し合うこと、②働く上での課題解決を図る際に、セルフアドボカシー（自分の権利を適切に主張すること）スキルや自己決定スキルを開発して適用させていくこと　③ソーシャルスキルや服薬管理を学習すること、④職場環境においてナチュラルサポートを受けること。　しかしながら、現在精神障害、発達障害のある人への職場定着に関連した認知行動療法に関する報告がなされつつあるのですが、精神障害、発達障害のある人が勤める職場環境への介入についての有用な実践報告は少ないのが実情です。　認知行動療法の基本原理である個人と環境との相互作用という視点をもつことが、有用なアプローチにつながることが示されています。個人と環境の双方を丹念にかつ客観的に把握するアセスメント技法が多くの支援現場で用いられています。　アセスメント結果を踏まえた随伴性マネジメント（望ましい行動があったとき、あるいは望ましくない行動がなかった時に、目に見える形での報酬や罰を与えて、望ましい方向を促進する関わり方）、セルフモニタリング、SST、認知的介入などが適用されていることも明らかにされました。今回は、以下の論文から学ばせて頂きました。キャリア教育と就労支援における認知行動療法の現状と可能性—知的障害・精神障害に焦点を当てた展望—著者：池田　浩之1　　千田　若菜2　　戸ヶ﨑　泰子認知行動療法研究，50(2), 67–76, 2024doi: 10.24468/jjbct.22-024

2025.03.25

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『慢性めまいの治療戦略としての認知行動療法』から学んでみよう

【たいせつなこと】　めまいは比較的多く報告される病気です。１年以上続くことが多く、その結果不安などの気持ちを感じさせたり、日常生活をいろいろと生きにくくします。　認知行動療法はめまいの治療方法として、有効であることがわかってきています。認知行動療法を上手に使うことで、問題を整理でき、様々な行動や工夫をする結果、問題を解決したり自己管理を上手に行える能力を高めることができます。また、認知行動療法は薬物療法と比べて、同等以上の効果を発揮します。【具体的な重要情報】　めまいは一般有症率20～25％と比較的多く報告される症状の一つです。有症者の74％は症状が1年以上続き，不安症状や機能障害が生じます。　認知行動療法（CBT）は、めまいに対する有効な治療方法としてエビデンス（科学的根拠）を積み重ねつつあります。　「持続性知覚性姿勢誘発めまい（PPPD）」に対し、CBTの有効性が報告されています。PPPDは，めまい症状を有する患者うち、14.4～20.8％を占めるそうです。無治療のままでは寛解（よくなること）が見込めず、苦しむ患者が多い病気です。　認知行動療法とは患者の問題を認知・行動モデルに基づいて患者と治療者が整理し，様々な取組を通して問題解決スキルや自己管理能力を獲得することで，問題の改善・解決を目指していく治療方法です。　よくある慢性めまいの症例を仮定してみます。典型的な認知行動モデルを用いると，めまい患者の障害の一部を認知，気分・感情，身体，行動の悪循環として捉えることができます。　一方、めまいにおける不安-回避モデルからとらえると、不安・恐怖回避モデルから平衡機能障害の結果生じためまいに対す考え方（破局的思考）は、不安・恐怖，警戒心や回避行動をまねきます。　それが長期化することで二次的な問題（抑うつや活動制限など）が生じ，めまいに対して過敏反応するという悪循環モデルとなります。悪循環を理解し，それらを形成する要因に働きかけることを通して，悪循環からの脱却を目指す必要があります。　認知行動療法は対象となる疾患の発症因を問わないため，他の慢性めまいの治療にも有効である可能性があります。患者の発症の仕組みや症状が維持される状態が，認知行動モデルや不安・恐怖回避モデルから理解可能で，抑うつ・不安，生活機能障害が認められる場合は，認知行動療法の適応となりえます。　薬物療法と有効性について比較してみましょう。PPPDや心因性めまいに対しSSRI，SNRIなどの有効性が報告されているすべての指標において、CBT群は薬物療法群と同等の効果が示されました。　つまり、CBTと薬物療法は、少なくとも同等の有効性があることが示されました。CBTは薬物療法と二者択一の関係というわけではなく，併用することがより効果的である可能性も指摘されています。　前庭リハビリテーション（VR）もまた，慢性めまいに有効な治療法です。VRは前庭機能の回復を目標とします。　CBT技法の一つである内部感覚曝露は，めまい感覚をあえて生じさせ曝露させる（≒体験させる）というVRとの共通点を持っています。内部感覚曝露は，不快な身体感覚とそれに伴う不快感情をあえて回避することなく味わい，不快な身体反応や感情に対する破局的思考の修正や，身体感覚と感情に対する慣れを狙う方法です。　VRと内部感覚曝露には異同があるが，場合によってVRを内部感覚曝露として活用できる可能性があります。【参考情報】「持続性知覚性姿勢誘発めまい」とは？　2017年に国際学会で診断基準が新たに策定された病気です。発症すると、雲の上を歩いているような浮遊感や不安定感のあるめまいが3ヵ月以上持続します。今回は以下の論文を学ばせて頂きました。『慢性めまいの治療戦略としての認知行動療法』著者：姜静愛，田中恒彦，八木千裕，堀井新　各氏Equilibrium Res Vol. 83(4) 229–234, 2024

2025.03.24

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『大学生を対象とした不眠症に対するデジタル短期的認知行動療法による睡眠の変化』から学んでみよう

【たいせつなこと】　今回の実験は大学生を対象に行われましたが、そもそも日本人の多くの人が睡眠に関する問題を抱えています。その結果、健康を害しやすくなったり、日中の活動が邪魔されたりしています。　そうした睡眠に関する問題を解消する方法はいろいろありえますが、本実験で活用されたのは短期的認知行動療法でした。日本人は学校などで睡眠に関する学習プログラムを提供されないことが多いです。しかし本プログラムは、多くの学生の睡眠に関する問題を改善するのに役立ちました。【具体的な重要情報】　国民健康・栄養調査（厚生労働省, 2020）によると、20〜50歳代で1日の睡眠が 6時間未満の割合は、男性37.5%、女性40.6%です。睡眠自体や生き物としての個人差と比べて、社会時刻は画一的の為、慢性的な睡眠不足の蓄積を引き起こし、心身への支障をきたす「睡眠負債」を抱えるようになりがちです。睡眠負債は日中機能障害（昼間の活動を効果的に行えない）に影響を与えます。　睡眠で休養が十分とれないと感じている大学生は44.8%です。眠りの浅さ、起床時に眠気を感じることがある者は77.6%に上ります。学生の多くは睡眠時間が短い傾向にあり、休養は十分ではない可能性が高いといえます。　デジタルを介した大学生を対象とする不眠症のための短期的認知行動療法（digital-Brief Behavioral Therapy-I: dBBT-I）として、「NECパーソナル睡眠コーチ」を実際に使用して、今回の実験は行われました。　調査の結果、研究期間中に約7割の回答率が認められ、AIS（アテネ不眠尺度）の平均が有意に減少し、睡眠の改善が認められました。AISを構成する因子である夜行性睡眠問題と昼間の機能不全の両方とも点数の改善がみられました。また、平日の実際の睡眠時間と理想の睡眠時間の乖離も少なくなっており、全体的な睡眠の質の改善へとつながっているといえました。　現代の学校教育には睡眠について学修するカリキュラムは組み込まれていません。一方、認知行動療法は手軽さや有害事象がほとんどないリスクの低さ、従来の実績、などから日本人の睡眠の質を底上げするのに役立つと考えられます。加えて本実験における有効性も観られました。　一方で、1割未満ではあるがdBBT-Iを完遂しても不眠が改善されなかった対象者もおり、該当者には改善に向けた適切なシステムへつなげる必要があることが示唆されました。　実験における問題としては、研究に対するドロップアウト対策の改善が挙げられます。原因の１つは、アプリのわかりにくさ・使いにくさにあると思われます。【参考情報】「短期的認知行動療法」認知行動療法をベースとします。パソコンやアプリを使用して、課題の設定、行動の記録、結果の明治、簡潔な指導などを受けることができます。「NECパーソナル睡眠コーチ」のアドレスhttps://www.nec-solutioninnovators.co.jp/sl/sleep-coach/index.html東京家政大学教授　岡島義氏が監修。有料サービス。今回は以下の論文から学ばせて頂きました。『大学生を対象とした不眠症に対するデジタル短期的認知行動療法（dBBT-I）による睡眠の変化: パイロット研究』著者：春田優菜氏　他各氏：加藤千穂　神徳備子　岡島義　江藤宏美看護科学研究 vol. 22, 77-89 (2024)

2025.03.23

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『遠隔での認知行動療法』から学んでみよう

【たいせつなこと】　うつ病の人にとって、人と会ったり、外出するなどの行動を起こすことは、おっくうだったり、つらいときがあります。しかし、近年はオンラインでの認知行動療法のカウンセリングもできるようになってきました。しかも、オンラインでのカウンセリングでも、実際にカウンセラーと面会して行うカウンセリングと同じような効果があることがわかってきています。【具体的で重要な各情報】コロナ禍において、オンラインの活用が更に普及しました。問診程度で対応できるケースでは、遠隔地に対して認知行動療法を提供できるという利点があります。対面式と遠隔式の心理療法の治療成績の差は無いことがわかっています。心理療法で大切なのは一般的に治療だけではなく，そのプロセスのなかで深まる信頼感や親密さ，期待感，満足感といった側面も大切になります。これらの指標についても遠隔式と対面式では差が認められずむしろ，アクセス負担に関しての満足度は対面の心理療法と比べて遠隔式のほうが高い場合もありました。国立精神・神経医療研究センターの認知行動療法センターが存在しています。・認知行動療法センターサイトは「認知行動療法センター」となります。（2025.3.22現在）・認知行動療法における権威である大野裕氏を顧問として、精神医学的及び心理学的にとても信頼性の高い治療を提供してくれると私は分析しました。・基本的に、精神医療機関を受診中の方は、対面式でのCBTが行われます。一方精神医療機関を受診していない方は、オンラインカウンセリングが実施されます。・セルフヘルプの方法の紹介も充実しており、大野氏による動画解説も準備されています。・問題点としては、CBTとは？で紹介されている書籍の一覧が、初心者向けではない書籍もたくさん紹介されていた点でした。（2025.3.22現在）ビデオ会議心理療法は実行可能であり，さまざまな治療形式でさまざまな対象に使用されており，一般的にユーザーの満足度が高く，従来の対面心理療法と同様の臨床的効果があることがわかりました。参加者のうち，86％（25/29）がビデオ会議によるCBTに満足し，83％（24/29）が対面CBTよりもビデオ会議によるCBTを好むという結果も示されました。考察として、自宅での受診による安心感が作用しているのかもしれないとのこと。加えてアニメやゲームの活用も効果を上げている。ゲームとして「SPARX」が施策されているとのことです。・「SPARX」はニュージーランドのオークランド大学の精神科医チームによって開発されたＣＢＴに基づくロールプレイングゲームです。・日本ではスマートフォン向けに販売されている模様です。価格は2000～2200円でした。（2025.3.22現在）今後の課題としては、しっかりとしたエビデンス（理論・証拠）を根拠としたプログラムやアプリの開発が必要である点です。セルフワーク（自分だけで行っていく）においては、セラピストからの適切なフィードバックが無いため、対面式の実施と比べて脱落率が高い問題は残ります。今回は以下の論文から学ばせて頂きました。著者：吉田斎子氏　関陽一氏『遠隔での認知行動療法』子どものこころと脳の発達　Vol.15　No.1　2024　P27-35

2025.03.22

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『大人の注意欠如多動症の認知行動療法』から学ばせて頂く

【大切なこと】　ADHDは「注意欠如多動性障害」と言われます。必要とされる注意をうまく使えなかったり、不必要に活動しやすくなる障害です。ADHDがある方は、他の発達障害と比べても多いとされています。脳のはたらきが未成熟であったり、成長・生活する環境の影響から、症状が出やすくなっています。　ADHDによって「生きづらさ」が生まれてしまいがちです。それを治療するには主に薬物療法と心理教育が有効です。心理教育の中でも重要なのが、認知行動療法、ソーシャルスキルトレーニング、環境調整の実行などです。特に認知行動療法には薬と違って、服薬が終わっても効果が残る（成長できる）効果を期待することができます。【重要な詳細情報】ADHDは「注意欠如多動性障害」と言われる障害です。遺伝的要因と環境的要因の双方によって、神経心理的基盤が形成されます。その神経心理学的基盤において脳の機能が低下し，不注意，多動性-衝動性などの中核症状に影響を与えていると考えられています。成人期のADHDの特徴は①他の発達障害に比べて人口が多い②成人期においても症状は残存しやすい③気分障害や物質使用障害などの併存症を発症しやすい④社会生活を破綻させるような経済的および対人関係上の問題を抱えがちという内容が挙げられます。ADHDにおける実行機能仮説とは，実行機能のなかでも「抑制」を支える前頭前野などの関連する脳のいくつかの部位が生後十分に発達せずに，成人早期までに不十分な状態で成長がとまってしまうのではないか？という説です。実行機能には①優先順位を考え順序立てて物事に取り組むために必要な能力②衝動コントロール③いちど作ってしまった認知の仕方（認知セット）の転換も含まれます。そうした実行機能が不十分な為に、いろいろな「生きづらさ」をまねいてしまうのです。なお、実行機能の欠如は、社会的な必要に迫られる青年期〜成人期に発見されることが多くなります。ADHD患者には，3つの神経心理学的基盤が想定されています。①刺激への反応を抑制する力を含む実行機能を司る前頭前野の成熟が定型発達者よりも遅いため，計画の立案や、順序立てに困難がある。②報酬系（例：何かしらの行動に対するごほうびをもらうこと）の障害のため，すぐに「ごほうび（報酬）」をもらいたくなること。③時間の見積もりが甘かったり、時間経過を感じにくい等の時間処理障害。ADHDに対して、各国でいろいろな治療ガイドラインがあります。共通しているのは、小児期のADHD患者の場合には，まずは薬物療法よりも環境調整や心理的支援が推奨されることです。一方、成人期のADHD患者の場合には，症状の重たさが中～重程度の場合、まず薬物療法が推奨される傾向があります。ただし、薬物療法だけでは成人の20〜50％が薬物療法に反応がみられないか，副作用などの有害な反応がみられるデメリットも観られます。そうした薬物療法のみで対応するデメリットを解消する為に、心理的支援が有効だとされています。特に各ガイドラインで共通して推奨されているのが，「心理教育」です。これは、まず本人がADHDの一般的な症状について知ります。次に自分の困りごとをADHDという観点から整理して理解します。そして日常生活をうまく運んでいくための対処法を学ぶといった一連の治療プロセスとなります。ADHDに対する具体的な治療方法としては、集団に対して働きかける内容と、クライエント（患者）が自ら行うものとに大別できます。集団認知行動療法では，「注意持続訓練」，「自己報酬マネジメント法」，「時間管理法」「対人関係上の問題を解決するためのソーシャルスキルトレーニング」などが提供されます。一方患者自らが行うものとしては、「環境調整」，「整理整頓」，「アンガーマネジメント」「認知再構成法（適切に認知を修正する方法」があげられます。＜各技法の簡単な紹介＞注意持続訓練：関係のない刺激に注意を向けず、必要なことに注意を向けられるようにする訓練です。たとえば簡単な計算問題を一定時間行い、合格点をとる。そうしたら、次の段階に移るという段階を踏んで、次第に注意持続できる量・質を高めていきます。自己報酬マネジメント：生活上望ましいのだけれど、面倒くさいなどと感じてしまってやりたくないことに対し、それをやったらすぐに好きな「ごほうび」をあげて、回避してきたことをすぐにできるようにする方法です。たとえば屋外作業員の方が朝起きたとき、必要な天気予報を確認するのが面倒だけど、実行できたら推しアイドルへの投げ銭権利〇〇円をゲットできるなど。時間管理法：文字通りです。手帳などを使って、計画して行動する方法をならったり、１時間、１０分間といった時間の長さを体感できるように支援するなどの訓練を受ける場合もあります。環境調整：苦手だったり繰り返してしまう問題を解消するような環境へと変えてしまうこと。たとえば出かけに鍵をしめるのを忘れがちであれば、玄関とびらの内側に大きな張り紙（カギ閉める旨の注意）をはっておくなど。自分自身でリマインダーのような行動をセットすることも有効です。（例：張り紙を見た時、必ず鍵をもった手で指差し確認をして、必ずその手で鍵を閉める行動を決まりごとにする）整理整頓：文字通りです。あれこれと注意がちらばって、まとまりにくくなる状態を防ぐ効果が高い方法です。ソーシャルスキルトレーニング：社会生活を送る上で、生きやすくなれる実践的な方法です。たとえばミーティングで発言するときに、いきなり本題から早口で話してしまい損をしている場合。発言の前にまず「発言内容の話題を必ず参加者たちに示した」上で、話始めるようにする。その際、相手の理解を助けるだけでなく、自分が早口であることを意識して、その抑制に努めるようにする。（「」の部分が形に表れた実行の部分です）アンガーマネジメント：怒りを感じた時に、それをしずめる効果的な方法を教わり、上手に実行できるようにする自己管理方法です。たとえば怒りを感じたら、まずは１０秒間必ず数を数えるようにするなどがあります。認知再構成法：自分を不幸にする非現実的で、自分の助けとならない考え方を、現実的（適応的）で自分の助けになるような考え方へと修正します。例えば、NG「私は最大効率で要件をなるべくたくさん相手に伝えるべきだ。そうでなければ私は無能者になってしまう。」　→　OK「私は今まで早口で多くのことを話しすぎてきた。そして相手から理解しづらいと言われてきた。それを認めよう。そして、大切な要件を相手に理解してもらえるよう、ソーシャルスキルを活用しよう。その方がむしろ有能な行動であり、自他の役に立てるというものだ」へと修正することで、焦りを減らし、望ましい行動へと変容させます。※この認知再構成法（認知修正）については、本ブログの『わかりやすい認知行動療法シリーズ』を最初から取り組むと、セルフワークでも出来るようになっています。なお現在の日本において、ADHDに対して認知行動療法を活用する上での問題点は主に２つあります。①長期経過観察データの不足（Lopez at al., 2018）②アプリによる介入研究が盛んだが、脱落率が高い。（但し治療者と共に取り組む場合、脱落率は低くなります。また魅力的なアプリの開発によって、脱落率をおさえる試みもすでに行われています。）今回は以下の論文から学ばせて頂きました。著者：中島美鈴氏『大人の注意欠如多動症の認知行動療法』Jpn J Gen Hosp Psychiatry（JGHP）Copyright ⓒ 2024 by The Japanese Society of General Hospital PsychiatryVol. 36, No. 3

2025.03.20

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『生活習慣病の認知／行動療法』から学んでみる

【大切なこと】　今の日本での暮らしは、食べ物が豊富にある一方、便利なので運動不足になりやすくなっています。その結果、生活習慣病になりやすくなっています。生活習慣病とは、悪い生活習慣が続くと起きてくる病気のことです。代表的な病気として、肥満、糖尿病などがあります。（他にも、がん、心臓病、脳卒中などが含まれます）　生活習慣病を防いだり治すためには、健康に悪い生活習慣を変えていく必要があります。その方法の中心的な役割を果たしているのが、認知行動療法になります。【具体的な内容】　日本の食生活の欧米化や車社会の発展は、高カロリーを摂取する一方、運動不足を招き、生活習慣病を発生しやすくしました。生活習慣病に対して、薬物療法だけではなく、生活習慣の変容法が重要な治療と位置付けられています。そして変容法の中心的な役割を果たしているのが認知行動療法です。　生活習慣に影響を与える主な要素には、第1に食事、運動、睡眠、喫煙、飲酒、休養といった日常生活のしかたがあります。第2に仕事の取り組み方、対人関係への取り組み方等の生き方や価値観を含む行動様式が含まれます。不健康な生活習慣は生活習慣病の発症や継続を招きますが、そうした不健康な生活習慣を正しく直す為に、認知行動療法が欧米で用いられ、実績をあげてきました。　認知行動療法には、単に治療するだけでなく、治療後に再び同じ問題を起こしにくくする効果があります。つまり、認知行動療法を実行した人の成長をもたらします。認知行動療法には、次のような特徴があります。①短期間での治療を目指し、問題解決志向であり、問題再発を防げるような成長を促進します。②過去ではなく、現在と未来に焦点を当てます。③はっきりしたわかりやすい手本を示せる。④治療者からの支援を受ける場合、一緒になって治療に取り組める。⑤セルフヘルプ（自力でマイペースにて行える）　なお、認知療法と行動療法は、もともと別の性格を持っていましたが、今では統合された技法になっていると考えて差し支えありません。　標準的な行動療法では、①食事療法の実施　②運動療法の強化・習慣化への取り組み　両者を併用しながら行いますが、治療終了後に放置すると（≒体重管理を意識しないと）３～5年で効果が消え、大部分が元の体重に戻るそうです。ですから治療後、いかに減らした体重を維持できるか？が、行動変容する治療上の重要なポイントとなっています。　では行動変容のための治療技法には、具体的にどのようなものがあるのでしょうか？第1の方法は「セルフ・モニタリング」です。毎日の食事内容、運動、体重等をシートなどに記録します。ポイントは①なるべく簡単な記入方法で行い、面倒くささを減らす　②数字を盛り込む　③色分けなどで一目でわかりやすくする　などがあり得ます。　　第2に方法は「ストレス管理」です。ストレスは不適切な飲食を招く引き金になりやすいです。今までの努力を投げ出してしまうきっかけにもなりえます。ですので、認知の修正、ソーシャルサポートを受ける、アサーション訓練をして実行する、コーピングを実践するなどして、上手にストレスを管理することが大切です。　第3の方法は「刺激統制法」です。簡単に言えば、思わず不適切に飲食したくなる環境を変えていこうという方法です。自分が不適切に飲食してしまう場面を分析して、誘いの効果があるものや要素を無くしていくのです。例えば家にお菓子があるとつい食べてしまうならば、家にお菓子を買い置くことを止めることで、すぐにお菓子を食べられる環境を変えてしまうことができるわけです。　第4の方法は「反応妨害／習慣拮抗法」です。飲食したいという強い欲求は、時間の経過と共に弱まる性質を持っています（反応遅延の法則）。ですから、飲食したいと強く感じたときに、「私は本当に食べたい？おなかが減ってる？これって偽の食欲じゃないの？」と自問するくせをつけたり、ストレッチしたり、シャワーを浴びてみたりと、気軽に実行しやすい気分転換を行うことがポイントです。　第5の方法は「問題解決技法」です。不適切に飲食したいと感じさせるきっかけとなるような、日々直面する問題を見つけ、解決方法を考え、解消する為に認知を修正したり、何かしらの行動を行ってみるわけです。シートに記入することで、分析しやすくなったり、考えがまとまりやすくなります。今後、同様の問題が起きた時の資料としても役立ちます。　第6の方法は「随伴性マネジメント」です。簡単に言うと、体重管理に役立つ行動を実行できれば、ご褒美をもらえるという方法です。　第7の方法は「ソーシャルサポートを得る」です。家族、友人、信頼できる職場の同僚、カウンセラーなど、本当に協力してくれそうな人を見つけて、長期間にわたり支援を受け続けることです。　第８の方法は「認知再構成」です。認知修正とも言います。食べることばかりを考えてしまうクセ（＝選択的注意が働きすぎている状態）、過度の一般化（今回もどうせだめだ。もう全部むなんだ。等）、白黒思考（良いか悪いかなど、極端に考えること）などに対して、認知再構成を行うことが特に有効です。　第９の方法は「再発防止訓練」です。予め、今後失敗することを想定しておきます。そしてそれが発生したとき、事前に用意しておいた健全な認知への修正方法、修正する為の実行方法などを実行するという方法です。小さな失敗ですら、すべてを投げ出すきっかけとなってしまうような問題を防ぐ効果が見込めます。　第10の方法は「目標設定」です。文字通り目標を設定して行います。摂取カロリー、体重、運動量などを決めておきます。理想としたい目標の7割程度の負担が無難です。　第11の方法は「食行動修正」です。いわゆる早食いをやめ、よく噛むようにして食べます。わざと利き手でない方で箸を用いるのも有効です。　　長年にわたる肥満治療のデータがたまったおかげで、肥満治療における問題点が明らかになりました。それは体重を減らすという目標と、減らした（減りつつある）体重を維持するという目標の区別があいまいだったことです。つまり減らすだけでなく、維持することにも十分に意識を向けて注力することが大切だったのです。　肥満治療中にクライエントによく起きる問題は、第1に段々と減量スピードが落ちてきて、計画通りに進まなくなる場合です。治療をあきらめてしまい、しかも減らした分の維持もやめてしまいます。第2に自分の行った頑張りの結果を、本人がちゃんと素晴らしい結果であると評価できない為、投げ出してしまうことです。　Cooper＆ Fairburの両氏は上記内容を把握した上で、以下の方法を提示しました。１．まず減量することと、維持することは別物であるとはっきりと区別します。２．減量期を開始します。減量の途中で、次の目標が「維持」であることを受け入れます。また減量期における無理な目標設定などを修正します。３．効果的な体重管理の為に有効な認知修正の仕方、行動の仕方をさらに学び、実行します。４．更なる減量を実施したい場合は、まず目標値の設定が現実的であるかどうか？　必要であるかどうか？などを十分に検証します。５．更なる減量の実施が妥当的である場合、最低でも半年間以上の維持期を経た上で、次の減量期を開始する。今回学ばせて頂いた論文は著者：野崎剛弘氏　須藤信行氏『生活習慣病の認知／行動療法』Jpn J Psychosom Med 51:1088-1097,2011となります。

2025.03.19

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『不安障害に対する認知行動療法』から学べる大切な点

【大切なこと】　強すぎる不安を感じてしまうと、日常生活を生きづらくなってしまいます。不安はもともとあなたのからだを守る為の感情です。でも危険がない状況でも、不安を感じすぎてしまうと、逆にあなたの人生の質を下げてしまいます。ではどうすれば、強すぎる不必要な不安を取り除いたり、やわらげることができるのでしょうか？その方法の１つが認知行動療法なのです。2012年時点で日本には有効なセルフヘルプのプログラム（自分で自主的におこなっていく内容）が無かったそうですが、当ブログの『わかりやすい認知行動療法シリーズ』は、セルフヘルププログラムの１つにあたります。【要約】　不安の問題の緩和・解消を目指す際、「不安」という心理学的現象が有する特徴を考慮すべきです。不安は一般的に認められる「身体を守る為の情緒」です。そして病的な不安が改善された後も、一過性の強い不安問題が残存することが少なくありません。従って、不安障害の改善は、単に病的な不安の改善だけでなく、その後の不安に対する「管理」をどのように行うか？が大切になってきます。その管理方法の１つが認知行動療法（ＣＢＴ）なのです。認知行動療法は強度の不安障害の改善だけでなく、治療後の不安管理までも意図した有効性の高い成果を誇っています。【具体的で大切な内容】・症状のセルフコントロールを目指すことによってＣＬ（クライエント）の生活の質（QOL）の改善と再発防止をねらうところに力点が置かれます。・ＣＬ自らが問題を適切に理解するところから始まり、認知行動療法を実行（介入）した結果、どのように望ましい方向に変化したか？という治療評価に至るまでの一連の作業となります。・不安は個体の生存の為に必要な基本情動であり、本体適応的です。しかし実際に危険が無い場合の不安は不適応的です。QOLの低下を招くので、もとの状態に戻すか、緩和するかを目指します。・不安障害では、自分自身が自動的に発してしまう「誤った警報」に対して、過度に防御反応することが学習されてしまっています。「誤った警報」とは、身体を防御するために（≒自分を安全にするために）発動する警報のことです。・不安症状には生理的、認知的、行動的側面があり、それらが同調しながら、不安反応を形成します。不安反応を回避する行動は、生活を妨害してＱＯＬを下げます。・特に不安誘発刺激や、不安生起場面からの回避行動が顕著です。不安を回避すると一時的には安心を得られますが、それがＱＯＬの悪化を招き、また悪循環を強化してしまいます。（なお回避・強化はオペラント条件付けとなります）・CLは刺激に反応するというより、刺激の主観的解釈に反応しています。つまり主観的解釈とは自分なりに解釈してしまうことです。その解釈には、スキーマと自動思考が強く影響を与えています。加えてCLはネガティブな知識が豊富であり、選択的注意も働かせてしまうので、余計に不安に注目してしまいがちになります。・CBTの実施により、治療後の海馬、橋、小脳での糖代謝の減少が認められており、CBTの有効性が神経生理学的裏付けがあると言えます。・パニック障害に対する治療法としては、エクスポージャー、内部感覚エクスポージャー、リラクセーション、認知修正、選択的周囲の修正、呼吸訓練が有効だと言われています。・社交不安障害に対する治療法としては、エクスポージャー、応用リラクゼーション、SST、不安管理訓練、認知療法という、行動的要因と認知的要因の両者を含む治療パッケージが有効だと言われています。・PTSDに対しては、長時間エクスポージャー、認知療法、ストレス免疫訓練、EMDRが有効であると言われています。・脅迫性障害については、心理教育、暴露反応妨害法、認知療法が有効だと言われています。・CBTの欠点としては、①時間がかかる為に費用対効果が低く、治療方法としての選択が見送られる。②エクスポージャーなどの導入を適切に行わない場合のドロップアウト等のリスク。③ホームワークが発生する為、ＣＬに負担が生じる。の3点が挙げられます。・日本におけるＣＢＴ導入の課題としては①治療マニュアルの開発と普及が不十分　②セルフヘルプ機会が無い（当ブログの『わかりやすい認知行動療法シリーズ』はセルフヘルプ支援に該当します）　③児童思春期の不安障害への対応不足（約10％の児童が不安の問題を抱える。また不登校児童においては不安・抑うつに関連する有病率が30-50％と高い）　④治療者の教育・育成（治療者が少ない）　⑤日本における治療実績が少なく、保険適用が不十分。の5点が挙げられます。今回学ばせて頂いたのは、以下の論文です。著者：板野雄二氏『不安障害に対する認知行動療法』精神経誌（2012）114巻9号

2025.03.18

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キャリアシートの活用目的と作成方法について

キャリアシートの活用目的と作成方法について【キャリアシートとは？】　いままでどのようなキャリアを歩んできたか？（例：どんな仕事をどのように行ったか。それによってどんな経験やスキルを得られたか？等）をまとめて、現在の悩みや今後の課題などの情報を共有・整理する為の道具です。【キャリアシートに盛り込む項目とは？】　具体的な内容を説明する前に、大まかに確認しておきましょう。第１に盛り込む内容は、過去・現在・未来の３つが挙げられます。第２にキャリアとあるので仕事で学び成長できたことを、時系列で具体的に整理しておきます。第３に仕事以外で学び成長できたことも、盛り込みます。第４に自分が感じたり考える主観と、事実である客観という二つの概念を意識します。その上で、具体的にどのような内容となるのかを確認していきましょう。【テーマの設定】　これは必要不可欠です。つまり面談の目的は何なのか？をハッキリさせておくわけです。例えばサポートが欲しいことと、希望する部署に異動してやりたいことにチャレンジしたいことでは、目的が大きく違ってしまいます。方向性をお互いに合わせておけば、効率的で、効果的なキャリア面談を行えます。【各項目】１：現在の課題・悩み・スキル上の問題点　それぞれ明確に明示して、その理由と共に簡潔に記入しておきます。なお面談者は、質問されたらさらに詳しく説明できるように準備しておきます。２：短期・中期・長期目標　それぞれを明確に明示します。できれば、それぞれの「キャリアパス」を調べておいたり、「キャリアプラン」を仮に立ててみると良いです。３：今後に向けた希望４：必要だと感じるサポートの内容５：自己評価において、自分の短所・長所を共に盛り込む６：自己評価において、失敗（から学べたこと）と実績を共に盛り込む７：仕事以外で学び成長できた点を盛り込む８：人生や日々の暮らしで大切だと思えることを明確にしておく（価値観の提示）９：検査済みのデータを添える（例：VPI）10：自分の仕事上のキャリアを、時系列でまとめておく。（作成方法は職務経歴書と同じです）11：保有する資格・スキルを列挙する。【レイアウト上のポイント】・人が一度に理解できる文章量には限りがあります。ですから、記入する内容は必要な情報を盛り込みつつ、簡潔にするよう心がけましょう。・見出しを上手に使うことで、相手の理解を助けることができます。・図を活用する方が効果的な場合があります。図・文章による長所・短所については『【図解972】　図解と文章は「わかりやすさの質」が違う』がわかりやすい説明でした。※リンク申請ができなかったので、リンク先を貼れませんでした。

2025.03.18

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『日本における心理士によるうつ病に対する認知行動療法の系統的レビュー』から学べる大切な点

【大切なこと】うつ病はそれほど珍しい病気ではありません。日本では16人に１人が、一生の間にうつ病にかかるそうです。認知行動療法には、うつ病治療において確かな効果が認められます。１０人の内８人は最後まで治療を続けることができています。認知行動療法の効果は日本だけでなく、アメリカやヨーロッパでも確認されています。児童から高齢者まで、幅広い層で効果が観られています。何より素晴らしいのは、認知行動療法は抑うつ症状を改善するだけではなく、あなたの成長を促してくれる（社会的機能を高める）働きがある点です。そして薬と比べて、効果のある時間が長くなる特徴を持っています。（私からのお誘い）少しでも興味があるならば、認知行動療法に取り組んではいかがでしょうか？今回は次の論文を学ばせて頂きました。著者：佐藤寛氏　丹野義彦氏『日本における心理士によるうつ病に対する認知行動療法の系統的レビュー』行動療法研究，38（3），157−167，2012　

2025.03.17

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コーピング入門編

＜はじめに＞現代社会を生きる私たちは強いストレスにさらされています。強いストレスは私たちの心身に悪影響を与えます。しかし私たちには強いストレスをやわらげたり、（一部を）無くしたりする技・スキルがあります。その中の１つが「コーピング」と呼ばれる技なのです。＜ストレスを感じる仕組み＞ストレスの原因は「ストレッサー因子」と呼ばれます。そして「ストレッサー因子」には次の５種類があります。・物理的なもの　例：せまい部屋・科学的なもの　例：排気ガス・生物的なもの　例：蚊にさされる・社会的なもの　例：共産主義国で言論の自由が無い・心理的なもの　例：親が常にけんかしていて、心が休まらないそれらは「ストレッサー因子」として、あなたにいろいろな「悪い反応」を起こします。悪い反応には・心理的反応（例：恐いと思う）・身体的反応（例：頭痛が起きる）・行動的反応（例：過食する）などがあります。つまり、あなたの身の回りにはストレスになりそうなものがたくさんあり、それらをストレスだと感じてしまうと、あなたの心身に悪い影響が出てしまうのです。ストレスが長い間続くほど、影響の悪さも悪化してしまうのです。そして先ほどお伝えした通り、「コーピング」を使って、みなさんにはストレスと向き合い、対処してもらいたいのです。コーピングの種類はいろいろとあります。１．問題焦点解決型２．社会的支援探索型３．情動焦点解決型（認知的再評価型）４．気晴らし型５．否定型６．回避型でも、あわてたり、ひるんだりしないで大丈夫です。１～６をあなたの性格・環境に合わせて、できる範囲で組み合わせて実行すればよいからです。では１から順番に詳しく説明していきましょう。１．問題焦点解決型これはストレッサー要因に直接働きかけて解決していこうという方法です。つまり「ストレスの原因を消してしまおう！」という発想です。問題を根本から解決できるというメリットがあります。しかし、計画を立てて実行したり、頑張らないといけない大変さもあります。ですから、協力してくれる人たちがいると、ぐっと成功しやすくなります。環境に問題があるならば、環境自体を変えることがとても有効です。（例：とある愛煙家社員の社内が禁煙になった際、喫煙ブースを作ってもらった。）２．社会的支援探索型簡単に言うと、カウンセラーや保健所のソーシャルワーカーなどに相談したり、助けてもらうという方法です。質の高い支援を受けられる反面、いつでもすぐに助けてもらいにくい、頼りすぎてしまう、お金がかかる場合がある等のデメリットがあります。３．情動焦点解消型（認知的再評価型）ストレッサー因子はそのままにして、自分の感じ方を変化させる方法です。変化させる方法としては、認知のゆがみを修正する認知行動療法がとても有効です。４．気晴らし型とりあえずストレッサー因子をそのままにしておいて、自分の好きなことをしたりして気分を晴れやかにします。小休憩、ストレッチや運動でも効果があります。一番有名なコーピングかもしれません。５．否定型取り越し苦労を止めてしまう方法です。絶対に変えられないし、その問題を考えても仕方の無いとき（例：地球に巨大隕石が衝突する可能性が０ではないが、考えてもどうしようもない）などで有効です。６．回避型ストレッサー因子から逃げるという方法です。危険が非常に大きい場合（例：ひどいいじめにあっていて、命の危険がある場合に不登校を選択する）に有効です。また、対人関係のストレッサーにおいては有効度がかなり高い傾向があります。ただし、回避し続けると問題が更に悪化したり、大きくなる可能性も残ります。＜コーピングを実行しやすくする為のポイント＞・自分が苦しくなっていると、本当の問題は何なのか？自分はどう感じているのか？それ自体がわかっていない場合が多くなります。まずは問題があることを認めることが基本姿勢となります（その上でしたら、回避型の実行もとても有効です）・なるべく多く気晴らしの方法をリストアップしてみましょう。思いつかないときは、ネットで関連した記事を参照するとよいです。お金をあまり使わない、他人に迷惑をかけすぎない、時間をかけない、具体的にすると毎日気楽に行いやすくなります。例えば×：音楽を聴く○：嫌いな人の写真などを壁にはって、Adoの『うっせーわ』を聞きまくる！こんな感じです。・コーピングした結果、ある程度効果が出たら、それを有効だとみなします。・とにかく試しにやってみることです。いろいろと試すと、だんだん自分にとても効果がある方法が見えてくるものです。（私の場合は「ユーロビートを聞きながらの安全運転ドライブ」もコーピングの１つです。これは50歳位で発見しました）・時間がたつと「あれ？コーピングって具体的にはなんだっけ？」となりがちです。また「もっと良い方法があればなぁ」とも思ったりします。ですので、たまに自分のコーピングの知識を復習したり、新しく学んでみることも有効です。・「こんな大問題、コーピングできるわけねーよぉ！」と思えるときは、「小さく分けて、少しずつ解決していく」という姿勢が有効です。例えば寝る時間も少ないほど忙しい場合。会社を辞めることはできなくても、疲れの酷い日に、最寄り駅から自宅までタクシーで帰るなどです。＜自分の怒りのパターンを知っておきましょう＞自分の怒りのパターンを知っておくこともコーピングの手助けとなります。日本アンガーマネジメント協会が、あなたの怒りパターンを知るための簡単なテストを公開していますから、ためしにやってみてもいいでしょう。（私はうぬぼれが強い、他人への依存心が高い、白黒はっきりつけたがる、理屈っぽい、など）なお、怒りをコントロールする為の方法としては、・６秒我慢してみる。・その場をいったん離れる・今後をイメージしてみる。今怒ったら損だと思いとどまる。・過去の良い思い出を味わう。（例：目の前の反抗期の息子も昔は赤ちゃんだった）・前向きなセルフトークをとなえる。（例：また上司のかんしゃくがはじまったが、彼を変えることはできない。しかし私は冷静に対処することができる。）・怒りを数字化して、冷静さを取り戻す。（例：上司がかんしゃくを起こした瞬間は8ぐらい。セルフトークを言ったら5になったな...）・深呼吸する。３秒吸って６秒はき続ける。４秒吸って８秒でも可能。などがあげられます。＜おわりに＞私（著者）は最初、自分が期待するほど上手にコーピングできませんでした。なぜならコーピングは技・スキルだからです。つまり、いろいろと実行していくほど、だんだん上手になっていきます。また一度上手になっても、使わないでいたり、学ぶことを長い間止めたりすると、以前より下手になってしまいます。つまり実行することで、だんだんとあなたの役に立ちやすくなる技なのです。いかがでしょうか？今日からはじめてみませんか？

2025.03.13

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Let's live !! Chapter15

First, let's review what we learned last time. People who don't value themselves are people who rely too much on others. One of the reasons for this is that they are obsessed with perfectionism. In order to get out of perfectionism, it is important to face your fears, gently support yourself, and continue to make efforts such as cognitive behavioral therapy at your own pace.Comedian Takayuki Haranishi (FUJIWARA) has a gag called "I want to live!". It is a gag in which he declares "I want to live!" with great determination. Let's digress and explain about the final victory of "choosing to live".The desire to "die" is a common symptom in people with severe depression. In fact, in recent years, more than 20,000 people in Japan have chosen suicide each year.But! We don't need to commit suicide. If you use cognitive behavioral therapy, your symptoms will definitely improve. In particular, within the first few weeks of treatment, you will often see positive changes in your daily life. No matter how bad you feel right now, as long as you have the conviction that things will eventually get better, you can endure it. You are wrong to think that suicide is the only way to solve your problems!If you really want to die, first look at your true feelings and see if it is for "active" or "passive" reasons.First, I will give an example of a passive reason. You lie in bed thinking negatively, "I wish God would just let me die peacefully."However, if it is active, it is quite dangerous. If you think, "I'm completely hopeless, and I'm never going to get better. I have no choice but to kill myself!", remember this. Feelings of hopelessness are just an emergency bell that tells you to get adequate treatment!In fact, depression is a kind of "defense response" that humans (living things) respond to when they feel a threat to their life. In the first place, it is a reaction that says, "To live safely! This is not good!"1. You have a severe depression and a sense of hopelessness.2. You have attempted suicide before.3. You have prepared a detailed plan for suicide.4. You don't see any way to stop yourself.If any of these points apply to you, be sure to get professional help.What almost all suicidal patients have in common is an illogical sense of hopelessness and the belief that they are facing a major crisis that cannot be solved. However, once you confess your distorted thinking to someone else, such as a professional, you will feel a great sense of mental relief. This will give you hope for life and will divert you from dangerous suicide attempts.It is true that the illness of depression narrows the scope of your thinking. However, your narrow range of experience also narrows your thinking in some ways. It can be said that challenges (diverse experiences) broaden that scope.Now let me confess some of my upbringing. I was raised by people with very biased ways of thinking. Also, people close to me had mental problems. I didn't have any problems with food, but I was "poor in spirit" and felt very unhappy.Eventually, I realized that the person who could save and help me the most was myself. In my case, the books and teachings of psychologists such as Yasutaka Kokubu gave me hints. And little by little, I was reborn into a person who could deal with problems on my own.1. Cycle from Tokyo to Kagoshima.2. Try different jobs.3. Confess to the person I like, even if it's a long shot.4. Try leaving the family home.5. Try changing the friends I hang out with.6. Look deeply into myself through self-analysis, etc.7. Try imitating various people I respect.8. In about 50 pharmacies, deliberately assert myself by saying, "I love sex. Can you recommend some extra-thin condoms?" (CBT shame therapy)9. I went around singing loudly and a cappella in front of a dozen train stations. (This is also a form of shame therapy in CBT.)10. I thought that my confession would fail because I had no experience with women! So I lost my virginity to a prostitute.11. I worked hard to get a qualification and used it in my work and volunteer work.To be honest, I have tried so many things that I can't even write them all down. I thought that I had to do this to change the way I was raised, which had been so distorted.One day, I confronted my father and asked him, "Why didn't you educate me as a father?!" He replied, "That's something you learn at university!" That's the kind of house I grew up in. So I chose to raise myself by learning from people other than my parents.When I remembered this episode when I was young, I felt a little sad. But now I feel nostalgic and laugh when I think back on it. And I confess. I have no despair or suicidal thoughts at all. I used to be a person who, although weak, had suicidal thoughts and had negative automatic thoughts.Certainly, cognitive behavioral therapy can improve your life. However, I want to convey that people can greatly change themselves through life experiences (actions). This can often greatly modify your automatic thoughts. For people who are not good at or dislike thinking, it may be better to broaden the scope of their experiences rather than cognitive therapy.[Summary]You don't have to die at all.And you will eventually find your own happiness. In that case, support from a professional can be very helpful.Also, practicing cognitive behavioral therapy is very effective. Furthermore, gaining diverse experiences and broadening your horizons is also an effective method. There is a very high possibility that there are multiple methods that suit you. You and I are both developing. Let's continue to grow and be happy together.[Afterword]This is the last of the 15-part series. These articles are written for people who find English easier to understand than Japanese. Cognitive behavioral therapy has the advantage that it can be used free of charge, even by those with limited financial means. It can be done at your own pace. If you are experiencing psychological distress, I would be happy if you would try it.This series would not have been possible without the presence of David D. Burns, the author of "Goodbye to Bad Moods." I would like to express my sincere gratitude to him. I would also not have been able to create this series without learning from everyone, including Yasutaka Kokubu. I would like to express my gratitude to all the people who raised me.

2025.03.04

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Overcoming perfectionism　Chapter14

Let's review what we learned last time. The three elements of "approval addiction," "love hunger," and "work and study addiction (value dependency)" have the following formula.1. I get approval from others.2. I get love.3. I'm successful at work.Therefore, I must have value! And all three patterns depend on factors other than myself! If you can recognize this mechanism and improve it, approval addiction, love dependency, and work addiction (value dependency) will be resolved at the same time!In order to break the mechanism of the three patterns, it is very effective to get away from perfectionism. In other words, "being just okay." "Being moderate." This is the key to getting away from perfectionism. You may feel disgusted because you feel that your goals are low because you have high ideals. However, if you actually try to behave "just okay," you will notice that1. It's surprisingly difficult to behave just okay2. For some reason, you feel more satisfied than usual and are more likely to achieve results. I want you to overcome perfectionism and experience the fruits of true joy.（*There is a "Type A, B theory" in psychology. It was proposed by Friedman and others. If you are interested, you should look into it.）"Perfection" is the ultimate illusion of human beings. It may be the biggest temptation in the world. It may seem like it will bring you wealth and free you from difficulties. However, the more you strive for perfection, the more you will be disappointed. You and I are imperfect human beings, and the world is a developing environment created by such human beings.The first thing you need to do to overcome perfectionism is to increase your motivation to continue this method. To motivate yourself effectively, it is a good idea to make a table listing the advantages and disadvantages of being a perfectionist and compare them. You will be surprised to find that your own attitude is actually creating your own disadvantages.[Example of comparison]<Perfectionist thinking>Produce great work and work hard to ensure good results.<Harm caused by perfectionism>1. Your thoughts and attitudes become rigid and you lose flexibility, becoming overly nervous in order to produce good results.2. You are more afraid than necessary of making mistakes that are necessary to achieve good results, and you avoid risks and run away from challenges.3. You are always critical of yourself. You cannot enjoy your successes, and your life tends to become boring.4. You are always in a state of tension that makes it difficult to relax. As a result, you tend to feel more tired and have insomnia.5. As an imperfect human being, you are basically always prone to anxiety and depression.6. You are unable to forgive others. All humans hate being criticized. If you continue to criticize others, you will lose friends, and your ability to care for others and love others will disappear.7. You run away from necessary challenges and risks, and you don't get the results you want, and your world becomes narrow.8. The real world is ambiguous, and those with a strong sense of balance can grasp it accurately, but your perspective and way of thinking become biased and you become distant from the facts. As a result, you also become distant from calm and objectivity.Another way to overcome perfectionism is to confront fear. Fear is at the root of perfectionism. Fear motivates you to polish things thoroughly. When you try to stop being a perfectionist, you may feel great fear and anxiety. However, as a reward for doing so, you will be able to escape from the various harms that perfectionism creates.If you are actually afraid of getting out of perfectionism. Have you ever had people who did not care about you and unilaterally demanded perfect behavior from you?It may be that they were your "toxic parents." It's really scary, isn't it? But if you acknowledge the existence and influence of your toxic parents, and continue to implement the methods introduced below, you will surely develop a sense of self-confidence and independence.To overcome your fears, you need to clarify your automatic thoughts related to perfectionism and repeatedly counter them with realistic arguments (the familiar triple column method). It may be scary, but if you can endure them, continue to counter them, and tolerate the discomfort, you will be able to overcome your fears. Because fear is inherently an illusion. The sense of relief you feel when you transform from a struggling, troubled person into a hero will mark the start of a stronger, more confident approach to life.(Let's briefly turn to the topic of job hunting. When you are looking for a job, it is better not to assume that you will definitely get the job, especially if you really want the job. Ultimately, results are brought about by various factors. For example, even if you are perfect, if your competitor is also perfect and has connections, you will not be hired. It is unrealistic to expect a one-shot win. Rather, it is more effective to always give your best and get out of the attitude of getting results at all costs.)If you are the type of person who is too absorbed in one thing, when you decide your daily schedule, allocate time for each activity. For example, if you practice guitar, decide that you will only practice for two hours that day!Why are you more afraid than necessary of making mistakes? One of the thoughts at the root of this is, "If I make one mistake, it will have an impact and eventually everything will be ruined. (jumping to conclusions)". However, there are also good aspects to making mistakes. Because you can reflect on your mistakes, learn from them, and grow. In the first place, none of us can avoid making mistakes, as we are imperfect human beings.If you admit your mistakes and learn from them, you can change your practical actions. If the cause changes, the result will change. You are more likely to grow and be happy as a result of making mistakes.Being too afraid of making mistakes will prevent you from taking on new challenges. Trying different things (trial and error) is often necessary for growth or creating new value in business, but you will not be able to do that.Most people, except perfectionists, will not hate you just because we make mistakes. And in fact, people who try to do things perfectly are disliked by many people. It's ironic. (Of course, if you make the same simple mistakes over and over again and don't make an effort to reduce them, you may be disliked at work, etc.)Even so, you may feel strongly that you cannot fix it on your own. The idea that "weaknesses must be fixed by yourself!" What kind of philosophy is that? If you have a perfectionist mindset that is difficult to fix on your own, one way to do it is to confess it to someone you trust and work together to fix it. A professional counselor like me would be fine, but it would be better if it was someone you trust and feel is "competent." (This person is generally called a "mentor.")[Summary]People who don't feel valued by themselves. They are people who rely too much on others. One of the reasons for this is that they are obsessed with perfectionism. In order to break free from perfectionism, face your fears, gently encourage yourself, and continue to use effective methods (such as the triple column method). It's okay to do it at a moderate pace.

2025.03.04

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The results of work or study are not the same as a person's value Chapter13

Let's review what we learned last time.Why do you really want to be recognized ? It's because you have a deep-rooted bad thought that "I absolutely need to be cherished and loved by the other person!" It's the root cause of not only hunger for love (romance and being cherished), but even approval addiction.The third assumption among the deep-rooted bad thoughts (the first is approval addiction, the second is love addiction) is that "a person's worth is determined by what they have accomplished in life by competing and winning against others." This kind of value system is mainstream in Western culture. It's probably a way of thinking that is familiar to you, but it's actually a harmful and inaccurate concept. Despite this, the idea of being obsessed with one's own achievements is often seen in people who are passionate about business. In recent years, people have been forced to compete fiercely with others since childhood and have been educated with an emphasis on achieving something, so they tend to be particularly vulnerable to failures in their work.The first step to changing this attitude is to consider whether it is in your interest. Certainly, your achievements will "temporarily" increase your value and your sense of happiness. As a result, your motivation will also increase. However, as a result, you will be driven to improve yourself as a more valuable person, and you will start to try to avoid being "average". You will work hard to "win" and you will win, so you will think that you can like yourself even more!This excessive attitude means that when work or studies are going well, you will always be absorbed in work or studies, and you will not be able to feel joy or satisfaction in anything else. If you quit work or school, or if you do not achieve results, you will feel a terrible emptiness inside your heart. So you will become more and more addicted to work or studies. And when your performance does not improve, you will feel worthless. If you are not careful, you may even fall into a severe depression thinking that you are worthless and that you are not a "good person".If you are too absorbed in your work and do not take care of your family, distortions will inevitably occur. It can also damage your health. These things happen because you have not established your true self-worth, and it is clearly to your detriment.Success does not guarantee happiness. Success and happiness are not the same thing, and there is no causal relationship between them. Therefore, you should stop this futile pursuit of building tall buildings on sand. Your mindset, not your success, is the key to your mood, so the excitement of victory will soon fade. In middle age or early old age, as the illusion of glamorous success in business begins to crumble, more and more people seek treatment. They end up asking themselves, "I've been looking for success, but what is my life about?"Most people are by no means great successes, but many are still happy and are moderately respected by those around them. From this, it is clear that happiness and love cannot be obtained only from success. There is no connection between happiness and great achievements.If you have time, what kind of achievements did famous warlords in Japan's Sengoku period achieve, and how did they end up? Or what kind of lives did successful businessmen live after that? It would be a good idea to look into that. For example, in the Sengoku period, you should look into the life and aftermath of Takeda Shingen, and in business, you should look into the life and aftermath of Napoleon Hill. You will probably feel that happiness is not your forte.So how can you gain self-esteem regardless of your work performance? First, there is a practical and philosophical method. You need to realize that human "value" is essentially abstract and does not actually exist. Rather than seeking "value," you should seek satisfaction, joy, new knowledge, mastery, or personal growth and companionship in your daily life.Next, you need to understand that self-esteem is lost through self-blame and unnecessary and irrational thoughts. For example, the president of a local construction company is more confident than the president of a large company in a certain industry who continues to fear the wishes of the founder's parents.Next, you can gain self-esteem by treating yourself like your best friend. Treat yourself as you would treat an important customer. It may be surprising, but there are so many people who do not do this. (Actually, I used to be like that, too.)If you can't get away from the idea of achievement above all else, use the usual triple column method to add a realistic and objective counterargument. Let's take me as an example.[Automatic thinking]If I don't become a better counselor, I won't be able to achieve much, and I won't be praised as a talented counselor by everyone. (Caution! I don't actually think this way.)[Rational response]I volunteer as a counselor, but even so, I have been able to contribute to the other person in over 2,000 cases. If I become better, the quality and quantity of my contributions may increase, but I am still able to contribute and feel happy.I don't need to be seen as talented, so I plan to continue my activities anonymously. That way I can truly think about the happiness of my client and provide pure counseling that is not related to profit.In other words, the following formula emerges for the three factors of "approval addiction," "love hunger," and this time's "work-study addiction (value dependence)."I am recognized by others. → I have love. → Therefore! I must be valuable!Succeeding at work. →And all three of the above patterns depend on factors other than yourself. If you can recognize this mechanism and improve it, approval addiction, love addiction, and work addiction (value addiction) will all be eliminated at the same time!

2025.03.04

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Starved for love - I absolutely want to be loved and cherished -　Chapter12

Let's review the previous content. If being able to think for yourself is a healthy state, then being too influenced by the other person's thoughts because you want to be recognized by them too much is an unhealthy state.This time, we will get to the heart of the question, "Why do we want others to recognize us so much?" There is more than one "deep-rooted bad thought." Not only "approval addiction" that fears opposing opinions, but also "love dependence" that says "I can't be a truly happy and mature person unless I am cherished and loved by the other person. Love and perfect security are what I ultimately need for happiness" are also "deep-rooted bad thoughts." In order to feel happy, you do not starved for love - I absolutely want to be loved and cherished - your own strength, but always demand and rely on something other than yourself. "Dependence" is an attitude that relies completely on you. In other words, dependence is a state in which you cannot take responsibility for your own emotions.Love dependents have difficulty actually receiving love. Dependent people who tend to rely on others and seem to want others to do things for them in order to attract attention. The other person will sense it. Even if they can't explain it in words, they will sense something unhealthy in your mind (specifically, your strong dependency and the actions and behavior that cause it). Many people (unless they are trying to take advantage of your dependency) will be wary of getting closer to you emotionally. This is why it is very difficult not only to attract the other person's initial interest, but also to maintain a relationship even if you are able to do so. (Note: "dating" here refers to a romantic relationship in which both parties are satisfied and can grow as people. Or an intimate human relationship.)The more independent you are, the more at ease you will feel. Furthermore, your mood will not be affected by what others say or do. People don't always value everything about you, and they don't always act with love. If you learn how to love yourself, you will be able to be relied on by others and maintain a high self-esteem.If you still strongly insist that love is what determines your value, write down the benefits of that. Then make a rational counterargument (the triple column method). You will find that much of the satisfaction you feel is independent of whether you are with someone or not. Here is an example.[Current distorted true feelings]I have to get married, find a spouse, and have children. Otherwise, I am not even an adult. If I cannot enjoy communication with my spouse and children, I am a failure in life. My life will never be fulfilling.[Rational counterargument]It is certainly wonderful to get married, find a spouse, and have children, and live a fulfilling life. However, there are many people who get married, find a spouse, and have children, but do not have family ties, and suffer the pain of discord every day.There are also many people, including Mother Teresa, who have lived a fulfilling life despite being single all their lives. In other words, your attitude toward your own life creates independence and confidence, which in turn leads to fulfillment.Moreover, acting alone can be surprisingly satisfying. Prior satisfaction and actual satisfaction are often very different (usually increasing). For example, this is my own experience, but I once casually visited my alma mater. I was bored, so I just happened to visit it because it was nearby. I took a walk alone. I think the expected satisfaction level was about 20.When I actually visited, various memories (including being rejected by girls) came back to me. I also enjoyed watching the current students people-watch. I was unexpectedly satisfied. My satisfaction level was about 60. One way to improve the cognitive distortion of love addiction is to act alone and keep a record of the difference between your previous and actual satisfaction levels.In other words, love is something that makes you happy if you feel it when you are independent. Even if you try to cling to what you think is love, it is not an effective antidepressant or tranquilizer. If you depend on love and seek it too much, it may actually harm your physical and mental health and make you even more unhappy. Recognition from others. Love. All of these things bring you happiness and enrich your life when you are independent. If you depend on them, you will not be happy, but will be unhappy instead. Recognition addiction and love addiction work in the same way! [Summary]Why do we so desperately want recognition? The reason is that deep in your heart, you have a deep-rooted negative thought: "I absolutely need to be cherished and loved by the other person!" This is the root cause of not only your hunger for love (romance and being cherished), but also your addiction to approval.

2025.03.03

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Approval addiction　～You always want to be approved～　Chapter11

First, let's review what you learned last time. When you start cognitive behavioral therapy, there are many cases where you feel the effects and your anxiety disappears all at once. However, it is common for feelings such as anxiety to return. This is because you are ignoring the "deep-rooted bad thoughts" that make you anxious. By repeatedly asking questions to find these "deep-rooted bad thoughts" and correcting them, you can aim for remission.Approval addicts always feel too strongly that they want others to approve of them. What happens when others oppose you? They tend to think, "Someone opposing me means everyone is opposing me. In other words, there must be something wrong with me." This thought makes you feel anxious every time you receive opposition. However, even if there is a movement in the outside world that causes opposition, how you take it has a big influence on your way of thinking. Whether you make yourself feel good or not is ultimately up to your way of thinking.Let me give you an example. There was a woman who was suffering from her husband's problematic behavior. There were times when she had a bad relationship with her husband, and times when she had a good relationship. When I (the author) actually met her husband, I found that he had a very problematic personality due to problems with his upbringing, etc. Later, when the woman was in a good mood, she praised me, saying, "You (me) are a lot like my husband. You're kind. I think you get along well with my husband, and I think we'll get along well."It's true that she rated me quite highly, since she rated me the same as her spouse. But I was actually very disappointed. I also felt a strong sense of disgust. That's because I didn't want to be thought of as being similar to someone with a very problematic personality.What does this example show? It means that you think and judge for yourself how you feel. If you accept what the other person says, and you agree with it, you will feel what they say. If you don't agree with it and reject it, as in this example, you will feel differently.Of course, even if you don't accept what they say, you will still feel uncomfortable to some extent. For example, if you are constantly told "You're a loser!" all day long, even if you're not a loser, you will feel uncomfortable. However, you will not feel any further remorse or loss of confidence. On the other hand, if you agree that you are a loser, a variety of negative emotions will arise. You will live a life where you are easily influenced by others. Moreover, many people will criticize you in an unreasonable way. That is the reality. Moreover, we have evolved to be able to act in groups. Therefore, it is inevitable that we will be influenced to a certain extent by others and the environment.The more conscientious and talented you are, the more you will be concerned about cases where there is actually a problem with you. That is a great attitude. If the criticism of others is on point, accepting it, considering whether or not there is a need for improvement, and taking action to improve if necessary will be helpful to you and those around you.But even if there are problems or mistakes, are you worthless and should be criticized unconditionally? No, you are not. If the focus is on the problem itself, it is healthy and realistic, but if the focus is on the evaluation of your value, at that point it becomes unrealistic and different from the facts.It is true that being praised makes you feel good. It is also true that there are unpleasant aspects to being criticized. There is also a human instinct. However, if you believe that the evaluations and criticisms of others are always correct and continue to follow them, you are choosing a painful life of being at the mercy of others.Think back to the last time you criticized someone. Did you deny the humanity of the person you criticized? In most cases, you probably did not criticize the other person by morally condemning them. Nevertheless, if you overinterpret the other person's thoughts and criticisms and believe that you are low in value, you will only continue to suffer from approval addiction.When did you become approval addicted in the first place? The answer is probably when you were a child. It is caused by someone and the environment that had a great influence on you. Especially for small children, caregivers have the same influence as God. When you were a child, it was inevitable that you became approval addicted. You were purely a victim. However, when you become an adult, you can think about things realistically and make an effort to overcome this way of thinking. You need to do so if you want to be happy.How can you grow into an independent and self-reliant self? First, there was a way to become aware of the "tacit understanding" within oneself that causes approval addiction and correct it. (Please review "Previous content")The second method is to make a note of rational thoughts that will correct the distortion of one's cognition and continue to check them from time to time. According to one theory, people think about 50,000 times a day. If you leave it alone and do nothing, you will repeat the same distorted cognition over and over again. In order to replace that repetition with a healthy way of thinking, you check the contents of the note paper from time to time.Also, as I told you before, in order to weaken the neural circuits (neurons) of negative emotions and thoughts, it is important not to have such negative emotions and negative thoughts. It is almost impossible to stop thinking without doing anything. However, challenging it using cognitive behavioral therapy etc. can be quite effective.[Specific examples to write down in a note]1. People who disagree with you often have a bad habit of thinking irrationally themselves.2. Even if the other person's criticism is correct, it is a matter of learning from their mistakes. Humans are imperfect.3. Even if others make fun of you, there is no such thing as a "born loser." It is impossible to keep making mistakes all the time. Just remember the right things you have done in life and grow to do so in the future.4. Your wrong words and actions are only a part of all your words and actions. There is no way to conclude that everything I do is wrong because of that.5. Everyone has their own thoughts and personalities. When someone opposes or criticizes you, there may be some people who agree with you. However, it is impossible for everyone to agree in the same way. There are also people who use social skills to agree on the surface, but do not agree on the inside.*If you experience bullying in a closed space like school, there are cases where you can't help but think, "Everyone will do the same thing!" However, society is much more diverse in terms of people's personalities and environments than schools. Even if you are a student, it is definitely possible to create a situation where not everyone bullies you, such as by transferring schools or using free schools.6. Criticism and blame are unpleasant, but they will eventually pass. Try to focus on the things that you have enjoyed up until now and do those activities.7. Criticism and blame will not upset you unless you are involved in it.8. Criticism and blame of others usually do not last long.9. The content of the criticism and blame of others is honestly ridiculous and misplaced. How many people are objective and calm based on sufficient facts? Very few.Thirdly, try asking the person who is criticizing or blaming why they are doing it. It takes courage, but not only will it clear up the misunderstanding and improve the relationship, it will also have the effect of making you feel courageous and regaining your confidence.Except for actual physical injury or destruction of your property, there are two types of pain that people can cause. The first is being ignored (not being recognized for your existence), and the second is rejection. Rejection can also be a source of fear. Especially in romantic rejection, if you do not fit the other person's hopes, your hopes of getting along will be rejected and you will be treated coldly. It will certainly be disappointing, but this is not your fault. It's only a matter of the other person's subjective preferences. It's wrong to think low of yourself.The following are some ways to avoid being rejected.1. Don't look down on yourself and sell yourself short. Instead, work steadily to improve your self-esteem.2. Like the other person yourself. Greet them wholeheartedly.3. Find out, understand, and grasp the other person's preferences, show interest in them, and get excited about the topic of their preferences.Even in general rejections, the other person may subjectively reject you for their own reasons = selfish thoughts. Of course, that doesn't prove that you are a "bad person". Just like the other person, you! will accept and reject. You will get along with someone, or clash or fight with them. It's a normal fact of life.Humans are imperfect, so even if you are rejected because of your own imperfections, as mentioned above, it's fine. Don't be swayed by the other person, improve if you think it's necessary, and leave the imperfections alone if you think it's unnecessary.If the other person is a toxic parent or a bully, they may use rejection as a way to control you. You don't have to deal with this manipulative rejection. Even if you respond to their demands, it will result in a lot of frustration and will not strengthen your relationship. It will cause stress for the person being manipulated, but it will also destroy the person trying to manipulate. It is rarely effective and tends to create tension and anger.※For example, if your family is codependent, the situation will be serious and continue.However, if you realize that you have been manipulated for many years in your family relationships, it would be better to immediately start making efforts to improve your self-esteem while using cognitive behavioral therapy. In this case, you may be effectively continuing to be affected.Finally, we will talk about recovering from blame and criticism. Sometimes, despite your efforts to improve your relationships with others, you will receive criticism and blame. How can you overcome the emotions that arise in such cases?First, remember that life goes on and that disappointments here do not permanently diminish the value of your happiness. As a result of rejection and criticism, it is our own way of thinking that causes emotional damage, so by correcting that, we can recover from depression.It is also effective as self-catharsis to set aside 10 minutes a day to let out all your negative thoughts. However, after the 10 minutes are up, you should hold off until the next time. Be sure to correct any negative thoughts that arise during that time.[Summary]If being able to think your own way is considered a healthy state, then being too influenced by the other person's thoughts because you want them to acknowledge you is an unhealthy state.However, the other person's claims and thoughts are subjective. They are simply stating their opinions subjectively (based on their own selfish thoughts) and criticizing or blaming you.Accept that you are also a "human being" and that people are imperfect. With that in mind, try cognitive behavioral therapy and other methods every day to make your life a happy one at your own pace.

2025.03.03

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Uncovering deep-rooted negative beliefs Chapter10

Let's review what we learned last time.Negative emotions can be healthy and natural (e.g. sadness) or distorted (e.g. despair). When you feel strong negative emotions such as despair, try cognitive behavioral therapy to become aware of the distortion in your thinking. Then correct the bad cognition that created the distorted emotion. Continuing to make such efforts will also have the effect of preventing you from automatically feeling bad emotions.If you use cognitive behavioral therapy successfully, you will think that you have never felt so good in your life. Your heart will become clear as the snow melts with the arrival of spring, and your pessimistic thoughts will disappear "as if by magic".However! You may think that your worries have disappeared, but if the pessimistic thoughts that lie dormant in the depths of your thoughts continue to remain, you will definitely be attacked by a depressed mood and hurt again in the near future.So what does it mean to be truly cured?1. You understand the cause of the depressed feeling.2. I know how to improve my pessimistic thoughts, and I can carry out effective methods.3. I have confidence and healthy pride. Confidence is the psychology of accepting yourself as you are, and as a result, you can achieve appropriate results*. Healthy pride is the psychology of loving yourself and enjoying life regardless of whether you are successful or not.*Results are different for each person. For example, if you need to take your dog for a walk on time and without too much or too little, and you can do that, that is also an achievement. The size, difficulty, and how much money it makes are irrelevant.4. I can understand the cause of depression more deeply.What does it mean to understand the cause of depression more deeply in 4? It means understanding the "deep-rooted assumptions" that naturally give rise to pessimistic thoughts. There are five patterns in particular for these deep-rooted assumptions.1. When someone criticizes me, I feel like there is something wrong with me and I feel miserable.2. If I were a perfect person, I would be loved.3. If I am lonely, I will feel sad and miserable.4. My value as a human being is proportional to what I have accomplished.5. If I don't do it completely, if I don't feel it, if I don't act, I'm a failure.But in reality, it can be difficult to figure out which of your implicit assumptions fall into the range 1-5. That's where the important thing comes in: "how to continue digging deeper into your automatic thoughts."[Situation]It's your first day at work. But your supervisor, Senior B, is a new employee who joined the company three months before you and has no experience in the industry. Senior B didn't guide you kindly. He made sarcastic remarks and was mean to you. . .Your automatic thought: "B is a terrible person! He's been mean to me and talking bad about me since day one! I can't work with such a colleague in the future!"Cognitive corrective thought: "What have I learned about B after just one day of work? Maybe he just happened to be in a bad mood today. If I can reassure B that I won't be hostile, his attitude might change. Either way, labeling him as a terrible person after just one day may lead to assumptions. Let's think of various ways to get him to cooperate in the future and try to implement the most realistic ones."In this example, your thoughts include automatic thoughts such as "labeling, anticipating the facts, and all or nothing." However, the "way to continue digging deeper into automatic thoughts" proposed this time is to keep asking questions about the automatic thoughts that come to mind."B is a terrible person! He's been mean to me and talking bad about me since day one! I can't work with such a colleague in the future!"↓ (Why can't they work together?)"As a professional, he should behave in a guiding manner towards newcomers, but he can't do that, so I can't trust him!"↓ (Why should a professional behave in a guiding manner towards newcomers?) (Can't you work if you can't trust him?)"I'm sure I'm a person that other people don't like. And if they attack me, I'm powerless."↓ (Why are you a person that other people don't like? Are you powerless if they attack you?)"When other people criticize me, I believe that I'm no good (1). If I attack them, the people around me will attack me in the same way, so I'll end up lonely (3)."What do you think? In this example, the implicit assumptions included patterns 1 and 3 of the five patterns.By digging deeper like this, you can make clear the implicit assumptions that are always tormenting you without you realizing it. Of course, after this, you should make a self-supporting counterargument to all of your automatic thoughts. In the example above, it would be as follows:"B is a terrible guy! He's been mean to me and talking bad about me since day one! I can't work with a colleague like that in the future!"(Edit) It takes a certain amount of time to make a comprehensive judgment about someone. You can't make a judgment in just one day. Besides, even if B is a mean guy, I might be able to make many business partners and feel rewarded at work because of my high aptitude. In fact, there was a time when I felt that way in my work today."As a professional, I should be able to be guiding newcomers, but I can't do that, so I can't trust him!"(Edit) The other person is a newcomer who has been with the company for three months. Moreover, he is from a different industry and is in a difficult situation where he is being bullied by his seniors. It is unrealistic to expect such a person to be given comprehensive mental and technical guidance. Whether he can actually be trusted can be judged by his future words and actions, and in the worst case scenario, it can be considered sufficient if he can cooperate with me in the workplace."I'm sure I'm someone that other people don't like. And when they attack me, I'm powerless."(Edit) Is that really true? Then why do you have a best friend? Why do some people trust you and rely on you? Why do so many people smile when you treat them well? These facts prove that you can't be completely disliked by others, right?Even if you can't cooperate with B, you can still work with others to get the job done, right?You can decide your own value and enjoy life regardless of success without letting B make an unfair judgment of your value. In fact, even the baseball player Ohtani is not always valued up and down, being a success when he hits a home run and a failure when he strikes out."When others criticize me, I believe that I'm no good."(Edit) Do others really value me appropriately? The answer is no. It's unfair to them in the first place when they don't recognize my human value. I choose to love myself, believe in my own strength and way of life, and continue to exert it. This will lead to a much more constructive life."If I am attacked by someone, the people around me will attack me in the same way, and I will end up lonely."(Edit) That is not true. Compared to the extremely closed-off school days of childhood and school, there are many adults in society who think and act independently. If I continue to recognize and express my true self and fulfill my responsibilities, there will be a certain number of people who appreciate me for being that way. I will not be loved and appreciated by everyone, but the opposite is not true either.A belief that destroys you is like a "polluted water source" in the case of a river. If the water source area becomes polluted, as in the case of the Ashio Copper Mine, it can have a negative impact on many areas that run from the source to the sea. It will be harmful to drink, and it will be harmful to cook food with that water. It will also affect the growth of crops. That's how it is.Now, I would like to show some common mistakes that are often made when continuing to question automatic thoughts that have actually arisen, and examples of how to fix them.【Failure example】"My boyfriend made a date but didn't contact me. What's wrong?"↓ (Why am I upset? What does it mean?)"It's because it's terrible! There's nothing I can do, I can't stand it. "This way you won't get to the self-destructive beliefs (the root cause of the problem).【Example of correction】"My boyfriend made a date but didn't contact me. What's wrong?"↓ (Why am I upset? What does it mean?)"My boyfriend ignored me. He doesn't really love me."↓ (If so, what does it mean?)"There's something wrong with me. Something that makes me unlovable. Otherwise, he surely wouldn't have ignored me."↓ (If so, what does it mean?)"I'm ignored. I'm not accepted. I'm rejected."↓ (If so, what does it mean?)"It's probably because I'm not attractive, and I don't meet his expectations."↓ (If so, what does it mean?)"I'm sure I'll be alone and miserable forever. I'm a person who will never be loved by others anyway."↓ (Why is it so hopeless to be alone and miserable/not loved?)"Because I can't survive on my own! Because I don't love myself!"So what? In the failure example, we focused on emotions, but this time, we've arrived at a thought that creates painful emotions. 1. If you are not loved, you have no value.2. If you do not meet the other person's demands, you will be hated.3. If you are alone, you will surely be miserable.4. In fact, there is anxiety that you cannot survive on your own and pain that you cannot love yourself.We have reached the self-destructive thoughts in the collect example. If you repeat this training, you will notice. Thoughts that make you unhappy in various ways will naturally come to mind, but surprisingly, the origin of these thoughts is similar! You will notice the root cause of the self-destructive thoughts, and eventually you will be able to accept and correct them. In other words, "remission".Another way to clarify implicit hypotheses is to use the Attitudinal Distortion Scale (DAS). I think it can be done with "Goodbye, bad mood". Here is the essence. It is said that people have seven tendencies that encourage self-destructive thoughts.1. Approval dependency This is the way of thinking that decides your own value based on the evaluation of others. The stronger the tendency to accept the opinions and thoughts of others, the more sensitive one becomes to "what others think of him/her," and the easier it is to adapt to the words and actions of others more than necessary. Also, the anger and dissatisfaction of others makes one feel even more anxious and depressed.2. Dependence on loveThey become dependent on others, believing that they cannot live without their love. They tend to fall into feelings of inferiority and are more likely to blindly follow the other person's wishes. When people actually leave them, they are devastated. This can be said to be a state of love starvation, and because they are so desperate to obtain love, they become exhausted and are unable to devote their energy to what is truly important or necessary. In cases where the other person shows their love or cooperation in a violent or coercive manner, there is a possibility that they will continue to use such violence and coercion. Of course, the situation will become even worse.3. Dependence on performanceThe sense of one's own value, the sense of security that one can have fun, and confidence are all dependent on one's productivity. For example, the idea is that since I am the president of a company and earn 10 billion yen in annual sales, I must be a great person!4. PerfectionismBecause you always try to behave perfectly, you feel chronic stress and are never satisfied. To fix this, you need to face reality. By accepting yourself and no longer fearing failure, it becomes easier to take on new challenges. Ironically, by abandoning perfectionism, you are more likely to achieve better results and accomplishments than before.5. Reward DependenceYou deserve love and money.This is a state in which you believe that you are entitled to rewards such as food and drink. If this is too great, you will feel that you should receive rewards and will begin to demand them. As a result, your needs will often go unfulfilled, leading to depression and constant anger. Or, if you believe that you are entitled to them without making an effort, you will not take any positive action.6. OmnipotenceIt means that you have a strong sense that you are the center of the world. This does not mean that you are superior. It is the feeling that I have an influence on all people and events. It is important to recognize that both you and the other person are important and have individuality. In a good sense, it is to think, "Other people are other people. I am me." As a result, you will be able to build a truly cooperative relationship with the other person in accordance with reality. Sometimes you are the center. Sometimes the other person is the center. Since you do not always have to be the center, you will no longer behave in a pushy manner toward the other person. You will no longer try to dominate others. Ironically, as a result, you will often receive affection from others.7. AutonomyIt is the attitude of carving out your own life for yourself. You can find happiness within yourself. In other words, these are the flip side of having healthy cognition. When you (and others) are happy, you can live your life naturally, and when you feel unhappy beyond the natural range, you need to understand that your cognition is distorted and correct it by using cognitive behavioral therapy, etc. Something other than yourself does not make you happy or unhappy. It is your way of thinking about something that makes you feel happy or unhappy. This content is related to the fundamental principle of cognitive behavioral therapy.[Summary]When you start cognitive behavioral therapy, there are many cases where you feel the effect and your anxiety disappears all at once. However, it often happens that feelings such as anxiety return. This is because you are ignoring the "deep-rooted bad thoughts" that make you feel anxious.By repeatedly asking questions to find your "deep-rooted bad thoughts" and correcting them, you can aim for a complete recovery.

2025.03.02

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Don't confuse healthy emotions with distorted emotions Chapter9

Let's review what we learned last time.When you feel guilty, it's often not the problem itself that you feel guilty about, but about yourself for causing the problem. Moreover, there is even a danger that those who do not value you will use that feeling for their own bad purposes. Therefore, it is advisable for you to realistically understand the problem and try to act in a positive and concrete manner.Humans have feelings of sadness. Sadness is a healthy emotion and is natural. For example, it can be said to be a healthy reaction to the loss of a loved one or the disappointment of not being able to fulfill your hopes. On the other hand, distorted emotions also exist. For example, when you feel despair and think, "I'm done for, he/she is gone!"Sadness is not a distorted thought, so it is a natural flow of emotions and will pass with time. It will never lower your self-esteem. However, distorted emotions can drive you into depression and other conditions. The situation will not improve and you will remain in that state. When you feel distorted emotions, the real cause is "your distorted way of thinking." If you can eliminate this distortion, the pain of "real problems" will be much less, and it will be easier to deal with them effectively.For example, let's say you lost your precious mother at a young age. You were not able to be a good son to her. If you experience such a serious loss, you will feel intense sadness and cry. It is natural to feel such strong sadness. This is a healthy feeling. In such a case, while you are deeply saddened by the loss of your mother, you can also try to make the funeral as wonderful as possible, even while crying. If you have a wife and children, you will try to love them as much as you could not cherish your mother.However, what if you think, "I did not cherish my mother enough. I am a failure as a human being! I have done something irreparable! I am no good!" after the experience of losing your mother? Your time will stand still. You will continue to feel despair and guilt, and will not be able to live life positively. If you are not careful, you may even develop depression.What if you get sick or have a disability? When illness or other problems occur unintentionally, many people have a filter placed on their minds. Simply put, you naturally tend to think that because I'm not healthy, everything is no good.For example, let's say you hurt your knee and have surgery. After that, your condition will not return to normal. Then a filter will be put in place. If you don't fix it, you will only notice one bad thing after another.I can no longer run. That's it. I can no longer play sports such as baseball, or go to bowling or batting cages. I'm sure I can no longer work in various industries such as transportation. I can't even jog when I'm in a hurry. Everything! In my personal and professional life! I'm no good! If you think like this, you will always feel depressed and will not be able to take action.This is the terrifying feature of the filter. In reality, you can avoid losing your strength by training to the extent that you can, and even if you can no longer run or enjoy sports, you can find and practice other hobbies and fun, accept yourself, stop panicking unnecessarily, and live an active and realistic life. Leave the filter and don't despair! By the way, this is my own true story.Of course, it is difficult to think and act positively at first. Influenced by instinct and culture, humans naturally tend to see things in a negative light. However, by using effective skills such as cognitive behavioral therapy and improving yourself, it is possible to significantly reduce even the tendency to see things negatively.There are cases where people are tolerant (open-minded) of others but strict with themselves. They can be strict, critical, and merciless about their own failures and shortcomings. This is influenced by perfectionism. There is also a hidden idea that "taking responsibility for yourself is effective for your own growth and achievement, so you should do it actively." However, people who think like this believe that they should just be strict with themselves, even though the part inside the << is important, so the result is not good for themselves.When people fail at work, they often label themselves as "losers." But this is meaningless. They are heavily dominated by two things: the "mental filter" that naturally sees only the bad points and does not try to fix them; and the "negative thinking" that for some reason does not acknowledge all the things that went well. "I could have done more. I could have done better." You continue to think like this, and continue to get angry at yourself unnecessarily or feel incompetent.Economic value and human value are separate issues. Your true value continues to exist no matter what you do. You have dignity.Family and friends of people who commit suicide often suffer from guilt. They continue to suffer, wondering, "Why couldn't I prevent this!?" However, humans are not omnipotent. There are limits, and it was not something that you were particularly unable to do. In fact, there are many cases where even professional psychiatrists and counselors are unable to stop someone from committing suicide.We cannot stop all the irrational decisions that lead to someone's death. We cannot take responsibility for them. Even if you support them to the best of your ability and the results are not what you want, you now have a new responsibility to achieve your own happiness and health. The problem is not that you were unable to prevent the other person's death, but that you continue to have distorted thoughts about the incident.It is true that the death of a loved one is sad. I have cried many times myself. However, such "experiences of loss and grief" remind us that we can love and wish happiness on others. Deep sadness is a noble and very strong experience. Parting is very sad. But doesn't it also add to the richness of life?In recent years, a German clinical psychologist has made an interesting report and proposal. It states that if we continue to have thoughts that make people unhappy (e.g. feelings of despair, continued strong anger, etc.), we become more likely to have those feelings and thoughts. The reason is that those thoughts and emotions continue to stimulate certain brain circuits (neuronal circuits). Since it is a skill that we use all the time, it becomes trained, and even though we don't want to, it becomes easier to carry it out.Therefore, if you feel despair, using cognitive behavioral therapy, etc., and continuing to make efforts to avoid such feelings and thoughts as much as possible, it is thought that this can also have an aspect of suppressing the development of neuronal circuits that affect love. For more information, please refer to "To You Who Are Too Sensitive" (Klaus Bernhard).[Summary]There are healthy and natural negative emotions (e.g. sadness) and distorted emotions (e.g. despair). When you feel strong negative emotions such as despair, try cognitive behavioral therapy to become aware of the distortion in your thinking. Then correct the bad cognition that created the distorted emotion. Continuing to make such efforts will also have the effect of preventing you from automatically feeling bad emotions.

2025.03.02

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Let go of the guilt Chapter8

Let's review what we learned last time.Even when you are depressed, you may feel anger, so it is important to manage it. First, find out how short-tempered you are. Anger causes much more stress than the original problem. The cause is cognitive distortion.Analyze the cause and try out the methods introduced above that you think are easy to implement. This is one effective way to deal with it.Guilt caused by cognitive distortion is often caused by the following reasons.1. Your actions deviated from the moral standards you set for yourself and were no longer fair, so you did something you should not have done. Or, you failed to do something you felt you should have done.2. This "bad behavior" must mean that you are a bad person.3. In other words, the concept that "it's my fault" is at the heart of guilt.Remorse and regret usually criticize "actions." However, guilt targets "yourself" for criticism.I'll show you my experience. I was a teacher for a while. I resolved to love all the students equally. However, I realized that I couldn't build a trusting relationship with the students whose parents were monster parents, and I couldn't love them. I thought, "Oh my God! I couldn't love even one student. I should have loved all the students, but I'm such a bad teacher that I shouldn't continue teaching any more."I left the education industry with a sense of guilt, even though many students and parents loved me.This guilt developed into further negative emotions.1. I'm inferior and worthless because of my bad behavior. This thought makes me depressed.2. If others knew what I did, they would surely look down on me. This thought makes me feel ashamed.3. I'll be rewarded or punished. This thought makes me anxious.But we are imperfect human beings. Therefore, there is no need to exaggerate the feeling of failure and beat yourself up. However, you are labeling yourself as a bad person with your distorted cognition. This makes it easier for you to perceive (individualize) yourself as hurting the other person and think, "I hurt the other person because I'm bad."The other person is an independent individual. Therefore, they can respond to your words and actions appropriately. It is not your words and actions themselves that hurt the other person, but the other person is hurt because they agreed with you. Therefore, you do not have to take responsibility for the reaction that the other person's distorted cognition produces. However, there may be cases where being hurt is a legitimate reaction. In such cases, you intentionally hurt the other person. You should stop doing such things as much as possible.For example, you criticize your friend, "You are always careless and often break promises!" The other person will not be hurt if he thinks to himself like this: "I didn't tell you this, but the other day my mother collapsed, so I have to help out at the store and take care of my siblings, and it's hard. I'm even cutting down on my sleep time. I don't have time, and I can't keep a small promise accurately right now." In other words, he does not accept your criticism for a valid reason.On the other hand, you should stop intentionally criticizing others with malice. For example, if you are a parent and you scold your child for something trivial on purpose. You do this to make the child submit. The pain the child feels at that time is healthy pain from the perspective of conscience and morality. If you want to claim yourself as a person, please stop doing this.Also, the strength, duration, and results of negative thoughts are indicators that can distinguish between abnormal guilt and healthy self-blame and regret. If you are trapped by guilt, you will become stuck in a pattern of thoughts and emotions such as: 1. I feel guilty and deserve to be blamed. It's proof that I am bad.2. I am bad, so I deserve to suffer. This self-deprecating behavior pattern further strengthens the cycle of guilt. You will not be able to recognize your unrealistic tendencies and will not be able to escape.If you feel guilty and criticize yourself, you will not be loved or respected by others. Moreover, guilt gets in the way of a productive life. We do it even though there is no point in tormenting ourselves.However, when it comes to improving and transforming ourselves, it is easier to get results if you believe in yourself, relax, admit your mistakes, and reflect on them. In other words, taking care of yourself and doing the necessary reflection is the basic policy that will help you solve your problems and get rid of guilt.Here are four self-examinations to help you get rid of guilt.1. Have I done something bad or unfair on purpose? Or have I hurt someone unnecessarily? Or am I irrationally expecting myself to be perfect, omnipotent, and omniscient (a being who would never hurt anyone)?*For example, just by trying to live a healthy life, we may sometimes offend people who live a life that violates our conscience. It is inevitable for us as humans to hurt others at some point.2. Have I labeled myself as a bad person because of this act? Are you trapped in the idea of exaggerating small things, or the idea of generalizing that this time must be just as bad?*For example, I want to contribute to children as a teacher, but I got irritated and scolded my child. If you think that I am a bad teacher, then in reality, almost all parents and teachers would be bad people.3. When you do something wrong, do you try to analyze it realistically based on the facts, and limit it to realistic regret and pangs of conscience?*The word "bad" can have many meanings. For example, it is not no good just because it is bad, but when you are asked to make a judgment, you need to think realistically that "I tend to avoid reality without making a judgment."4. Have you learned from your mistakes and made and implemented measures for self-improvement? Or are you just continuing to do things that do not lead to any solution?*For example, if you want to study for the bar exam, but continue playing games while feeling that you are a bad person, it will not lead to a solution. This is despite the fact that various skills such as work excitement can be possible as improvement measures.Here are some ways to get rid of inappropriate guilt and improve your self-esteem.1. Daily record of distorted thoughtsThe method was to record using the triple column method or column method and correct it as necessary.2. Technique to get rid of "should thinking"First, if you notice that you are feeling guilty, ask yourself, "Who on earth said I have to do this!? Where does it say that!? Is it required by law!?" You will realize that you are criticizing yourself more than necessary.3. Use your ability to believe in yourselfIf you can also exercise your ability to believe in yourself, use it. I was able to overcome the problem of ○ in the past. So there is a good chance that I can do it this time too. You can think like this. On the other hand, think back to the time when you were the most satisfied and ask yourself if you were "bound by should thinking" at that time. The answer will definitely be NO.4. Know your own unreasonableness with the paradoxThere is also a method called the paradox. Think about the "should thinking" that you often do three times a day. 2 minutes per session. You can read it out loud or listen to an audio recording of it being read. Personally, I recommend reading it out loud like an actor, with a sense of perfection and no compromise. Then you will understand how ridiculous it is. You might even find it funny.Some of the things I have explained this time (the point about other people manipulating guilt) may be psychologically burdensome. So if you read on and feel it is "painful," please read or try it with the help of a professional or someone you can trust with confidence. Do not consult with people who are the cause of your guilt (e.g. toxic parents) under any circumstances.When talking about guilt, there are cases where it is very mentally painful and difficult to resolve. It is a case where other people are trying to manipulate you using this guilt.If you have a psychology where you have to be liked by everyone and please everyone (fear of losing love). People around you will start forcing you to do things without considering what you like or dislike, or whether you are interested in them or not.One way to counter this kind of forcing is called "assertion." It is a skill that can be quite effective once you get used to it, so try it out. Even if you can't be assertive, it is important to "refuse" by valuing yourself while valuing the other person.When supporting someone who is constantly complaining, you may feel guilty, which may increase your burden and prevent the situation from improving. In this case, even if you try to solve the problem for the other person's sake, the other person will continue to complain. However, if you get tired of it or get exhausted and try to stop supporting them, they will blame you, making you feel guilty and asking if you are abandoning them.In such cases, it is effective to continue agreeing with the other person. If you continue to acknowledge their complaints, it may become difficult for them to say more. This is because they will be made to realize the content of the complaints themselves.Let me give you an example. When someone complains to you, "I'm a bad mother because I always scold my children," you should not respond with, "That's not true. I always care about my children, so I'm sure I'm still regretting it." Try responding like this.For example, "I'm a bad mother because I always scold my children." → "So you feel bad because you always scold them." (Just agree) Continue this exchange. The person's goal is to feel better by venting their frustrations, so they don't want a constructive answer. Instead, this exchange may help the other person understand and accept the problem. It should also lighten your burden. Help them solve their problem without pampering them. Finally, I will explain what is known as "guilt over worrying about something that never happened." Worrying about something that never happened is when you feel anxious or scared about a problem that you cannot manage or control. If a problem occurs due to something that is far beyond your power or the power of humans, we cannot prevent it. Instead, if you try to recover from the loss in a positive and energetic way, not only will the problem be alleviated, but the problem will likely lead to new benefits and happiness.[Summary]When you feel guilty, it is often not the problem itself that you feel guilty about, but about yourself for having caused or having the problem. Moreover, there is even a danger that those feelings will be used against you by those who do not value you. Therefore, it is advisable for you to realistically grasp the problem and try to act in a positive and concrete manner.

2025.03.02

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Eliminate the causes of anger Chapter7

First, let's review what you learnde last time.If you are afraid that if the other person dislikes you, it's all over! You will believe that the other person's criticism and assertions are absolutely correct. You will become even more depressed and will not be able to express your feelings and thoughts.As one way to solve such problems, we introduced a method of actually communicating while practicing how to influence the other person.Even people who are depressed or suffering from depression often get angry easily. In order to properly face and manage anger, you should first know how short-tempered you are. If you are not used to self-evaluating, it can be surprisingly difficult. However, it is a good idea to take some kind of test or get multiple trusted people to evaluate you. First, understand the reality as accurately as possible.You may have gotten angry about many things up until now, but the important thing is to respond appropriately little by little each time you get angry, and gradually become able to manage your anger. Anger is a double-edged sword. It has some advantages in that it can temporarily relieve you, but if it explodes, it will last longer. (It's like when an alcoholic drinks to take the edge off.) Even if you're not at fault, you'll still feel angry. The pain caused by anger far exceeds the discomfort you feel. In addition to discomfort, it can also lead to a variety of physical illnesses, such as high blood pressure. That's why it's important to properly manage your anger.In most cases, anger is caused by a cognitive gap. By learning to deal with this gap in a more practical and functional way, you can make it easier to manage your anger.The first cognitive gap that causes anger is labeling. If you treat someone as stupid or incompetent, you will see them negatively. At that time, you will probably focus on the things you dislike, ignore them, or underestimate their good points. In other words, you will not be able to evaluate them as they really are. You will tend to make assumptions about the other person and nag them a lot, want to get revenge, or treat them the same way and seek revenge.Most people label others because they want to protect their self-esteem. For example, if you label your unreasonably strict father as "a shitty dad! A bald bastard! A pig!" in your mind, you can mistakenly think that your father, who you actually feel is superior to you, is inferior to you. It can also be considered a psychological defense mechanism.The second cognitive gap is "overreading minds." You think up an explanation that satisfies you about why the other person did what they did. However, that is not what the other person actually thinks. For example, if someone argues with my opinion, you misread it as "he must be arguing with me on purpose to make things difficult for me!"The third cognitive gap is "overinterpretation." When you think, "The bus is late. What a disaster!", how much does it actually mean that the bus is later than scheduled? People who have a strong tendency in this way may not be able to casually talk to members of the opposite sex. This is because you feel "how terrible!" when you are turned down by someone you've never met before.The fourth cognitive gap is "thinking that you should do it." Should thinking is caused by the belief that you will always be satisfied, and causes panic and anger when you are not satisfied with the situation. A typical example of this pattern is someone who always does their job honestly but gets angry easily. They feel that because they are doing a good job, they should always get a satisfactory result. They feel that others should cooperate.It is your belief that something is unfair that causes anger. In fact, anger is the opposite emotion to the recognition that you have been treated unfairly. However, fairness is relative. There is no absolute fairness. What seems fair to one person is not right at all to another. In fact, fairness is just a concept that you have created yourself.Let me give you a concrete example. How do you feel about a zebra being attacked and eaten by a lion? Young children and kind people may feel sorry for the zebra. I have this side to me too. However, since lions are carnivores, it is important for them to eat the necessary amount of zebras, and from the perspective of the food chain, it can be said that they prevent overpopulation of zebras and suppress starvation.Absolute fairness does not exist, but of course morality is important. However, much of our daily anger is caused by confusing our own hopes with our moral standards. In order to prevent this confusion, it will be effective to always be aware of the following two points.1. Is this anger directed at people who have shown malicious intent?2. Is this anger useful to me? Does it help me achieve my goals?The important thing in common is to control your anger and turn the situation to your advantage. Use it as a means to realize your desires. For example, suppose your boss has been making repeated sexual remarks on purpose. After feeling anger toward such a person, you can be resolute and calm and say, "This is sexual harassment and I will report it to the human resources department," which is an effective way of suppressing sexual remarks.Anger continues persistently. Since it arises from a moral sense, it is quite difficult to overcome it if you do nothing. However, there is a concrete way to deal with it. It is a method to compare the advantages and disadvantages of anger and revenge in a double column. Let's try using the above sexual harassment remarks as a double column.Advantages: You can suppress sexual harassment remarks, you can suppress unreasonable work orders, you can gain confidenceDisadvantages: You are seen as a scary person, you will be less likely to be approached by menList the specific advantages and disadvantages.Even after the initial trigger, anger can sometimes nest in your heart for decades! However! It is you who are perpetuating that image. You are hurting yourself. A good way to resolve it is to transform it into humor. Why not imagine the person you are angry at walking around in only their underwear, with a pacifier in their mouth, crying?It is also effective to forcefully stop angry thoughts. It is also effective to get into the habit of saying "Stop!" in your mind the moment you notice your anger. After that, imagine something you really like. It can be someone you are interested in, or sexual fantasies are also very effective. (Dr. Ellis, the founder of rational therapy, did this during treatment at a dental clinic and reportedly felt almost no pain.)Sometimes rules that make interpersonal relationships difficult don't seem bad at first glance. They can even seem moral.For example, the idea that husbands and wives should cooperate and do their best! Mutual cooperation is a temporary and unstable ideal that can only be achieved through continued effort. Common understanding, communication, compromise, and growth are all necessary, and it also requires hard work such as negotiation.If, nevertheless, a couple sets an unrealistic fantasy as a goal and continues to criticize each other, they will continue to be angry and will continue to lower the quality of their lives. In such cases, try "reconsidering the rules that should be."1. You won't always be thanked.2. Many people are polite, but some are not. Life is too short to waste it on the exceptions.3. Even if you work hard, there is no guarantee of success.4. It is true that you can get angry if you are treated unfairly, but is that to your advantage?5. It would be nice if others behaved the way you want them to, but sometimes that is not the case.Throw away unrealistic expectations. You can control your own emotions. Are you afraid that if you change your expectations and stop getting angry, you will become weak, or that others will take advantage of you? If it makes you happy and helps you achieve your goals, then be happy to stop. Rather than trying to change the other person's bad behavior, praise their good behavior and ask for their cooperation. This is called a "reward system."For example, if you argue and get angry every time you have a boss who is bad at nagging, you will not see any improvement. If you greet them, continue to express your gratitude, sometimes give them good compliments, and achieve results at work, you will be surprised at how much their attitude will change.To correct your thinking, try to decide on "average" as the middle point. The world is a very diverse place, so stop expecting perfection to always equal greatness. In fact, I am not the best counselor. Average is fine.A gentle and firm approach works better to get your point across without getting angry or confused. On the other hand, a moral "should" approach makes you angry and makes the other person emotional. The other person will become more defensive and will attack you in return. The gentle and firm approach is "negotiation." There are three points to negotiate.1. Instead of complaining, find something good and praise or flatter them.2. If the other person becomes combative, your first priority should be to calm them down.3. Calmly but firmly make your point of view clear.Use a good combination of these three and see it through to the end. Extreme ultimatums and threats are the last resort.Empathy is a great way to resolve anger. Empathy is the ability to accurately understand the thoughts and motives of others. Remember, it was your own thoughts, not their actions, that created your anger. Interestingly, the moment you understand why the other person behaved in a certain way, your anger will subside to a surprising extent. Humans are attached to their own perceptions, and before they know it, they behave toward others according to their own interpretations. Making meanings is "jumping to conclusions (overreading minds)."Finally, there are 10 things you should know about your anger.1. It's not what happens in the world that makes you angry. It's your "cognitive distortions" that cause anger.2. Anger alone doesn't help you. It reduces your energy and creates hostility toward you and yourself. However, if you try to find and practice positive solutions, you will feel better and the situation will be easier to improve. If you find yourself in a situation that is far beyond your ability to solve, you can temporarily escape from it. You can also think about the times and things that made you happiest.3. If you get angry frequently, your thinking is distorted.4. Anger is likely to occur when your moral sense is stimulated by the belief that the other person is being unfair or unjust.5. The words and actions of the other person that you perceive as unfair may not be unfair to the other person themselves.6. Other people think that you have no reason to blame them. Retaliation based on anger will worsen relationships and cause conflict. You may gain momentary self-satisfaction, but in the long run, it will have many negative effects.7. Anger often occurs when you lose your "self-esteem" when others belittle you, do not agree with you, or do not act the way you want them to. Stop relying on others to judge your worth. You can live your life by your own will. (Remember to follow your conscience if possible.)8. Frustration occurs when your expectations are not realized. This is likely to occur in the following situations:- The love, happiness, promotion, etc. that you desire should happen.- If you work hard, you will definitely succeed.- It is natural that others should put in an equal amount of effort as we do, and others should believe what we perceive as "fair."- I should be able to solve any problem quickly and easily.- If I'm a good wife, my husband will love me.- Others should be able to think and act the same way I do.- I've been kind to others, so they should return the favor.I'm sorry for the harsh language, but can you realize that your own expectations are unrealistic?9. Does feeling anger benefit you? If you act on your anger, it will be detrimental to you unless you manage it properly.10. To be human, anger is necessary from time to time. But if you manage your anger properly, that is, if you free yourself from being in a bad mood, you will find yourself with much greater interest, joy, peace, and motivation.[Summary]Even when you are down or depressed, you may feel angry at times. It is important to manage it. First, find out how short-tempered you are. Anger causes much more stress than the original problem. The cause is still cognitive distortion.While analyzing the cause, try the method you think is easiest to implement from the many methods introduced. This is one of the effective ways to deal with it.

2025.03.02

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Neutralize the criticism of others　Chapter6

As always, let's review what we learned last time."I don't want to do anything. I'm no good like this... I'm already all alone... I can't do anything..." Feelings like this were called "nihilism." There were 13 psychological states that make you prone to nihilism. By looking at these, you can deepen your understanding of your own feelings and state by thinking, "I see, I think I'm in a certain psychological state right now."After that, you choose a method that seems easy for you to do from the "11 ways to overcome nihilism" and try it out.The cause of emotional upset is not other people or their critical opinions. It is the "bad thoughts (automatic thoughts)" that come into your head when you are criticized by others that upset you. Emotions arise in response to these thoughts. And there is always a cognitive distortion in the thoughts that upset you.Now let's think about countermeasures. First, accurately identify the bad thoughts that arise when you are criticized by someone else. Then refute them.If someone criticizes you, they may or may not be right. If they are wrong, you will not be upset at all. Why should you be upset if someone else is criticizing you incorrectly?If the criticism is accurate, there is no reason to be overwhelmed. You do not need to be perfect. Simply admit your mistake and correct it.However, if you believe that you absolutely need the love and praise of others to be satisfied, criticism will be scary. This will force you to direct all your energy toward pleasing others, leaving you with no room for creative and productive living.Unfortunately, if you live your life with this attitude, some people will see you as a boring, unlikable person who is always concerned about how others feel.To learn how to approach others, it is effective to role-play. Below are some points to help you do this step by step.[Step 1: Help the other person to see the problem objectively]When asking questions to someone who has criticized or attacked you, avoid being judgmental or defensive. Always ask questions that seek accurate and clear information. Step 1 is the process of changing an exchange of attack and defense into cooperation and mutual respect.By asking accurate questions, you can reduce the possibility of the other person being rejected outright. Many people are more afraid of being rejected than necessary. Try to help both parties become aware of the specific problem, and ask questions to understand the situation and world as the other person feels it. Ask accurate questions and respond empathetically, even if the other person's criticism is completely unjustified. Find out what the other person is trying to tell you with their criticism.(Example of asking the correct question in the first stage)Boss: "You're so lazy! The deadline has passed, and you still have work to do! Get to work!"You: "I just want to confirm, what kind of work do you mean by "get to work on it quickly?"Boss: "You were supposed to proofread 60 more pages of the problem set! Stop procrastinating and get to work! Are you still a working adult?"You: "At last week's meeting, it was decided that I only need to proofread the remaining 20 pages by the end of this month. Mr. XX (your boss) was also there..."Boss: "Is that so? Sorry..."[Second stage... neutralize the other person]When you are criticized, you have two choices: to respond aggressively, to run away, or to stay there and neutralize the other person while sympathizing with them. To do this, first find a way to sympathize with the criticism, regardless of whether it is right or wrong.1. Find something that you can empathize with in what the other person is saying2. Avoid making sarcastic remarks or excuses.3. Always tell the truth.As a result, the other person's burning desire to attack will suddenly become powerless.When you are unfairly attacked, you will find that you have a deep desire to defend yourself. This is the root of the mistake. If you give in to this tendency, your opponent's criticism will only grow stronger. Every time you defend yourself, you only fuel his or her aggressive spirit.(Example of stage 2)Other: "You're a weird counselor."You: "I'm certainly a unique and eccentric counselor."Other: "There's no way you can treat people."You: "Of course I can't treat everyone."Other: "You should give up your counseling license!"You: "I'm sorry that I'm lacking in some areas. If this continues, we won't be able to move forward with counseling. But I'd like to work together to find a way to solve the problem and help you solve it. (Communicate honestly and sincerely.)"Other: "...I understand. I'm sorry..."[Stage 3...Feedback and Negotiation]Once you've neutralized the critic by using empathic techniques to listen to what they say and finding something you can empathize with, you're in a position to articulate and clearly explain your position and feelings.You can negotiate by showing that you may be wrong, while easing the other person's fear of being wrong.(Example of the third stage)Other: "I did a good job on the carpentry. So you have something to complain about?"You: "Yes, it really helped me a lot. My grandparents can now go up and down the stairs smoothly, and it's all thanks to the handrail that was installed."Other: "So why are you asking me to come and fix it again? How bossy!"You: "I don't mean to sound bossy. It's just my amateur opinion, but it seems like the creaking door on the second floor that I asked you to fix hasn't been fixed at all."Other: "Eh? ... Did they do that too?"You: "The other day, you rushed to do it because you had another job to do. Thank you for taking the time out of your busy schedule. But the creaking is so loud that it's bothering me, so I'd like you to come as soon as possible."Other: "Okay. Sorry! I'll make time this week to come and see you."On the other hand, when you're dealing with a critic, you may have a lot of opinions, but even if they keep pointing things out, sometimes it's better to firmly and politely repeat your opinion.Sometimes the conclusion is somewhere in the middle (i.e., a compromise), but it will still be closer to your own belief than the original conclusion.Feeling intense anger toward the critic can be a way to relieve anxiety and feel better. However, if you defend yourself against critical opinions in a defensive or retaliatory manner, it will be difficult to have a constructive relationship in the future. You may feel good for a moment when you explode with anger, but it will not produce good results in the long run. You also miss the opportunity to learn what the other person is trying to criticize. You will end up exploding with your emotions and punishing yourself in the end.People with depressive tendencies usually choose depression out of the three options of depression, anger, and joy. They automatically conclude that the other person's criticism is correct. They jump to the conclusion that they are wrong and have made a mistake without examining the whole picture. They overinterpret the other person's criticism as correct.So when someone criticizes you, try to gain insight into the following:・Is there even the slightest bit of truth in the other person's criticism?- What did I do to deserve criticism?- Am I really what the other person criticizes me for (e.g. useless)?- Make a decision calmly without making negative value judgments. Negotiate if you need to compromise. If you are completely wrong, admit it. If the criticism is wrong, point it out skillfully. You will then understand that your self-worth is not the problem.[Summary]If you are afraid that the other person will dislike you, it's all over!, you will believe that the other person's criticism and assertions are absolutely correct. You will become even more depressed and will not be able to express your feelings and thoughts.One way to solve such problems is to role-play and actually communicate while practicing how to approach the other person.

2025.03.01

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始まったばかりです何を書くかわか…

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