With Dr. D having taken early retirement, I am working with others while looking for a psychatrist to replace her. (Replace her? Surely not.)
The other day, I had a session with another Dr. D. By phone. From Vancouver. She walked me through an exercise of A-B-C-D which I really benefited from, and I thought I’d share.
“A” is for an activating event. In this case, it happened to be missing an earlier session with the new Dr. D. We’d scheduled one for Canada Day. Usually, I double check my calendar at the start of each day, to make sure I don’t forget things. Well, it being the holiday, I neglected to. So, I wasn’t home when she called.
“C” is for the consequences. Where “A” might be, say, a car accident, “C” would be a resulting traffic jam. In a psychological context, “C” will be emotions and/or behavior; positive or negative; healthy or not. In this case, the consequence was a bout of severe depression that day and the next. Suicidal-level depression.
Definitely negative, definitely unhealthy.
“B” is for belief system. The thought processes, rational and positive or otherwise, which one applies in an “A”-type situation – the interpretation, the “narrative”. The consequences of a car accident can be pretty concrete. But even there, beliefs are involved in rendering the results. Is the traffic jam maybe, just possibly, a moment to slow life down, talk to the passenger in a real way, enjoy Radiohead? Is seeing the accident maybe, just possibly, a reminder for all of us to drive more cautiously?
When it comes to the consequence that day, viz. of experiencing a severe depressive reaction, the role of my intervening beliefs was huge. What were those beliefs on July 1st? This is what the new Dr. D helped me sort through. That I forget things all the time. That I should have remembered. That I wasted a valuable appointment. That the new doctor would be deservedly angry — will judge me, will think I don’t really merit her help. (I mean, she interrupted her holiday weekend to meet with me.) That only I would do this.
“D” is for disputing: do I really have good evidence for the “story” I told myself, it in turn leading to the consequent depressive episode? She helped me see that I didn’t. I don’t forget things all the time. Mostly I remember – partly because I put a lot of effort into a system of reminders. Did I have reason to think that she’d be angry? I hardly knew her. She’s in a caring profession. In effect, I was implicitly judging her harshly! She also assured me that almost all of her patients forget appointments. It goes with the territory of treating folks with mental illness, she explained.
My homework for this upcoming week is to do more A-B-C-D exercises. And, when an “A”-event comes along next time, I’m to dispute the beliefs before the consequences get so huge.