Retrain Your Brain: Cognitive Behavioral Therapy in 7 Weeks by Seth J. Gillihan [Actionable Summary]

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The Book In Three Or More Sentences:

Your mind continues to be plagued by constant worry regardless of what you do? What Seth J. Gillihan offers in Retrain Your Brain is a 7 weeks program absent from academic jargon that will help you become your own psychotherapist. The book starts with an overview of what cognitive behavioral therapy (CBT) is. Why it’s the most-used treatment for those who suffer from anxiety and depression, and how it can assist you in regaining confidence in yourself. All in all, this is a how-to guide full of nudges to participate by writing things down. The text aims to teach you how to replace your damaging thoughts and behaviors with such that are healthy and motivating.

The Core Idea:

Our thoughts, feelings, and behaviors are closely related – each element affects the rest. The crippling thought of being late for work because of your demanding boss can generate feelings of worry and thus make you tremble in panic. The primary insight about CBT is that by modifying the initial thoughts that bring us to a state of unease, we can positively influence the way we feel and behave.

Reason To Read:

Anxiety and depression are conditions that are self-generated. Yes, surely outside circumstances are often a prerequisite for our depressive mood. But the prime source of angst comes mainly from the stories we tell ourselves. Understanding CBT will assist you in escaping the prison you self-created and start living with less fear.

5 Key Lessons from Retrain Your Brain:

Lesson #1: Before Cognitive Behavioral Therapy

It all started with behavior therapy.

In 1906, Ivan Pavlov, a Russian physiologist. Carried out an experiment to understand how animals make associations.

In the experiment, he would ring a bell and then give food to a dog. After a couple of ring > food; ring > food; ring > food rounds. The dog in the experiment would start to drool just from hearing the bell sound.

In the later years. Another famous scientist, B. F. Skinner. Discovered how behavior is shaped. In short, we punish an action to try to stop it or give a reward to encourage it.

Add a couple of more years, and psychiatrist Joseph Wolpe enters the scene with his anxiety treatment method called systematic desensitization.

The above three discoveries were the foundation of behavior therapy. The primary focus of this treatment is on understanding the fears/troubles of a person and assisting him in facing them. The goal was to create a list of things that resemble the uncomfortable situation. Then, tackle the things from the list starting from the easiest to the hardest.

After behavior therapy comes cognitive therapy.

The premise of this treatment is that our thoughts are what generate depression and anxiety.

In other words, your feelings are determined by your thoughts. And your thoughts are generated by what you experience in your day-to-day life.

If you are afraid of bridges, for example. Seeing one will generate a thought that will be something like: “I’m going to lose control and something bad is going to happen”. The thought itself will transform into fear and frantic behavior. Also, it will force you to avoid bridges and find alternative routes.

In these situations, cognitive therapy aims to help you understand your thoughts. Closely examining your thinking will make it easier for you to spot what instills fear.

“When we’re depressed, our thoughts are often hopeless and self-defeating. Again, in cognitive therapy, it’s important to figure out how our thoughts contribute to our low mood.” Seth J. Gillihan

Lesson #2: Understanding Cognitive Behavioral Therapy

The above two basically merged into what is now called cognitive behavioral therapy (CBT).

The founding principles remain pretty much the same, but there is a slight adjustment.

CBT says that our thoughts, feelings, and behaviors are tightly related and affect each other.

• Thoughts affect our behaviors and feelings.
• Feelings affect our thoughts and behaviors.
• Behaviors affect our feelings and thoughts.

Imagine this as a triangle where all the three connect to each other.

A neat example to understand it from the book is the following: “When we feel anxious, we tend to have thoughts of danger and want to avoid the thing we fear.”

Plainly, when our brain creates a thought of something we are afraid of, our body can feel paralyzed because of the fear generated by the thought (feeling). Thus, we’d want to avoid doing this action (behavior). And finally, our avoidance further reinforces our fear.

Using the example from above with the bridge, we’ll have the following situation:

• Thoughts: It’s not safe. I can fall. I’m a coward.
• Feelings: Fear. Discouragement.
• Behavior: Take an alternative route. Act apprehensively if you are a passenger and passing over a bridge.

To further help us understand CBT, the author shares the core principles of this treatment method.

Here are the main points:

• CBT is time-limited: A therapist who is using CBT won’t force you to visit him forever. There is a time constraint. The goal is for the patient to get maximum results in the shortest possible time. Also, a shorter course of treatment will motivate you to actively participate.
• CBT is goal-oriented: A big part of CBT is defining your goals. What do you want to cure? What do you want to accomplish at the end of the program? Having a good understanding of your goals will increase your progress.
• CBT is collaborative: It’s not about laying on a comfortable sofa and expecting the therapist to fix you. CBT is about working together with the therapist. He provides the techniques, but it’s up to the patient to tailor them to fit his goals and to use them.
• CBT is structured: There is a particular structure that is followed to rid you of unhelpful thoughts. Each new week of the treatment builds on the former. First, you build the foundations, and then you start to practice.

What else?

Well, I’ll leave you with this directly from the book:

“This is a “roll your sleeves up” kind of treatment, with treatment emphasizing tackling clearly defined goals head-on. Both therapist and client are actively engaged in the process.” Seth J. Gillihan

Lesson #3: Getting Familiar with Anxiety

Even if you’re generally a happy person. You’ve surely been suffocated by depressive thoughts at least once.

A lot of times. Anxiety can help.

Yes, that’s right.

After all, if you are not at least slightly worried about how you’ll have enough money to eat. You’ll spend your days watching TV and roaming the web.

Lack of worry means carelessness. And we need to care for a first date, a job interview, our projects, our kids to make things work.

The problem, obviously. Is when worry consumes all of our senses. When anxiety makes us dysfunctional and prevents us from doing our normal activities.

In the book, Seth J. Gillihan lists the main types of anxiety that adults can experience:

• Specific phobia: The irrational fear of a given object or a specific scenario. This category can include pretty much everything you can imagine: spiders, clowns, bridges, heights, elevators, etc.
• Social anxiety disorder: We avoid social interactions because we think we’ll embarrass ourselves. This fear makes us imagine what others think about us – regardless if it’s true or not. We say to ourselves things like: “They’ll think that I’m dumb!”; “Probably I’ll bore everyone!”
• Panic disorder: Panic attacks happen suddenly and paralyze the whole body. The actual moment when a panic attack happens is not the disorder. What we’re avoiding here is places or situations we think will trigger an attack.
• Agoraphobia: This type of anxiety is about avoiding places where we think something bad will happen. For example, public transportation, movie theaters, bridges.
• Generalized anxiety disorder (GAD): A person with GAD is uneasy all the time because he is worried about a large portfolio of things. Countless “what if” situations are going through the mind. And even if something is resolved. Another crippling thought takes place.

“Anxiety disorders are the most common psychiatric conditions that people experience. How likely are people to have a major type of anxiety at some point?

– Eighteen percent will have a specific phobia.
– Thirteen percent will have social anxiety disorder.
– Nine percent will have generalized anxiety disorder.
– Seven percent will have panic disorder.
– Four percent will have agoraphobia.
Women are about 70 percent more likely to have an anxiety disorder than men.” Seth J. Gillihan

Lesson #4: The Interfering of Safety Behavior

People who have social anxiety. Expect that they rarely go out or talk to others. When they do. They are completely consumed in their minds with what they are going to say next.

They try to construct a script for the conversation in advance to avoid awkward silence or the feeling that they are embarrassing themselves.

But this practice prevents the person from fully engaging in the conversation.

The author calls this safety behavior. Things we do when we are anxious.

For example, we try to memorize a script for our date or for an interview. Constantly checking in our heads to remember our script makes it impossible for us to have a natural conversation. All of this leads to a ruined experience.

The author suggests dropping the so-called safety behavior. When we do so, we can focus on the here and now. We start to hear what the other person says. When this happens, we truly listen. We can use what’s happening at the moment to continue the conversation instead of making it sound like an interrogation by using our pre-defined script.

This doesn’t mean that you don’t have to prepare for an interview, for example. The point is to realize that you can handle a conversation without fully relying on additional props.

It takes practice. Small steps. And convicting that you can do it.

“During your exposures for social anxiety, practice directing your attention away from yourself and what others think of you. You might choose to focus instead on the person you’re talking with and what they are saying, or on being in the conversation, presentation, or whatever you’re doing, rather than monitoring how you’re doing.” Seth J. Gillihan

Lesson #5: Seven Weeks to Relieve Anxiety and Depression

After the brief introduction about what is CBT and the general anxiety states that can hurt our lives. The book evolves into a practical seven weeks program.

To be honest, the text is not that different from a general self-help book. You set goals, you prioritize, you focus on what you can do first, and postpone what seems hard until you build confidence.

Seth Gillihan explains that this is the treatment plan he uses when he’s working with clients.

The goal is to go through all the components – seven weeks one by one – and actively answer the questions proposed in the book. Yes, the book is full of questions that want to help you better understand your issues.

Also, the author advises to don’t skip steps because the plan builds on itself week by week.

Below, I’ll share the main points from the program:

Week One: Setting Goals

In order CBT to work. We need to identify our specific pain points. Fear of heights or lack of motivation can be the things we are generally trying to heal, but there are always specifics. We need to understand why we fear heights – for example – and create a plan to overcome such situations.

• What brought you here? The first question a patient receives from a therapist is surprisingly simple: “Why you are here?” Then, “Why now – what made you decide to seek professional help now?” The answers will reveal important components of your current situation.
• Your strengths: We are not completely useless. Even if your thoughts are saying otherwise, you have certain strengths. Write down everything you’re good at. Ask your friends what they consider as your strengths.
• Taking stock of what’s happening in your life: This step is about writing down what’s happening in your life in six areas: Relationships; Education and career; Faith (Meaning); Physical health; Relaxation; Domestic responsibilities.
• What are your goals? The most important question to answer in the first week is this: “How do you want your life to be different at the end of these seven weeks and beyond?” Also, “What do you want to be different in your life?” Create a list of goals. This will be your north star.

Week Two: Getting Back to Life

Week two is all about getting more active.

Usually, when we’re upset. When we are feeling unmotivated. We tend to do nothing. We prefer to be alone in front of the TV eating ice cream.

This self-imposed idleness invites even more negative thoughts, which further deteriorates our condition.

“The fastest way to feeling better and staying better is doing the things that keep us feeling well,” says Seth Gillihan.

The treatment method in this chapter is called behavioral activation. As stated, it’s designed to make you move.

Here’s the overview:

• Decide what’s important for you: We prefer to stay at home instead of going out because we focus on the short-term rewards. But to move the needle forward, we need to participate in activities that are not so comfortable at first. The first step is to create a list of values based on your points from week one. Then, under each value, to list activities that will reinforce the first. A simple example is this: Value: Feel better physically; Activity: Exercise daily.
• Values and activities: Values shouldn’t have an ending. Feeling better physically is a continuous endeavor. As well as keeping your relationships healthy, for example. You never “complete” them. As for activities, the point here is to clearly define what you’ll do, ensure they are repeatable, and to schedule them at specific times in your week.
• Where to begin? After the list of values and activities is done. The author explains that we should score them from 1 to 3. Tasks that are with a score of 1 will be easy to do. And we will use 3 for harder ones. As you can imagine, the goal is to start with activities that are easier and gradually increase the difficulty.

Week Three: Identify Your Thought Patterns

Review the activities you performed last week. Write down the following for each activity: What went well? What could have gone better?

It’s normal if you don’t yet feel better after doing the tasks, says the author. After all, we are aiming for a long-term change.

Once you review your week, it’s time to get to the core of week three: Understanding our thought patterns based on what happens to us.

Most commonly, we create destructive stories that don’t competently represent reality.

For example, if we are looking for a job, and we get rejected. We’ll take it personally. The rejection will feel awful and ignite depression.

The author presents such situations in diagrams:

• Event: Passed over for a job.
• Thoughts: Nobody will hire me. I’m weak. I’m a loser.
• Emotions: Disappointed. Depressed.

The dangerous thing here is that we start believing that we are useless. This belief – labeled “core belief” – leads to more depressing thoughts. It’s like a loop that keeps us down on the ground. We start to avoid certain activities because of fear.

The exercise of this week is to pay attention when your mood dips. What thoughts appear in your head that lead to depression and anxiety? How do you feel? Write everything down.

Week Four: Breaking Negative Thought Patterns

It’s time to release thoughts that gravitate toward negative interpretations.

Commonly, we demoralize ourselves by focusing only on the negatives. If someone comments on our ability to do our job. This sole comment can become our reality and convince us that we are not good enough.

In most cases, however, the reality is much more nuanced. We are not a complete disaster. We simply persuade ourselves that we are.

With the exercise below. The author wants to help us see situations objectively – for what they really are, not what we convince ourselves they are.

“Challenging Your Thoughts” exercise:

• Event: Chose an event that supports a negative thought about yourself. Getting a rejection for a job, for example.
• Thought: Write down the exact thought.
• Emotion: How did you feel?
• Evidence for my thought: Description that supports the negative thought – you get rejected, etc.
• Evidence against my thought: Think about this: Is there any evidence against your thought, suggesting it might not tell the whole story? Being rejected from one company doesn’t mean that all the companies won’t hire you. Usually, there are hundreds of candidates. Besides, someone previously hired you, right?
• Modification: Based on the evidence, how can you modify your thinking to better-fit reality?

Week Five: Time and Task Management

It’s hard to find motivation when anxiety and depression are taking over. In such cases, we don’t feel like doing anything.

What the author suggests as a solution is not uncommon. Namely, breaking big tasks into smaller, manageable pieces.

Here’s the process:

• Identify your tasks: Think about everything that you need to do and write it down. Once you can see on a piece of paper what you need to do. You will probably be surprised that it’s not that much.
• Prioritize your tasks: Determine what’s important and what can wait.
• Create a plan: Create a more robust plan about what needs to happen and when. Add the most important things to your calendar.

The end goal of the whole exercise is to make the tasks manageable. Yes, writing a scientific paper, for example, is surely not easy. But if you plan to write one page today, one page the day after, and so on, you can surely do it.

Week Six: Facing Your Fears

How to overcome your fears?

Easy.

Expose yourself to more situations that trigger your fears.

Yes. Kind of scary but how else to overcome what frightens you?

This is called exposure therapy.

The goal is to gain a new perspective on what we are afraid of. In the general sense. We fear something because we think it’s dangerous. The key here is “we think”. Thinking something is dangerous doesn’t mean that it really is. It means that we make it dangerous.

When we face situations and nothing happens. We obtain new information about the situation and thus we feel differently about certain events – i.e., the fear is gone.

The framework here is to make it progressive.

Here’s an example:

If you’re afraid of giving a presentation in front of an audience. You can start by sharing your ideas with a friend. Then attend an online event and talk to fellow participants. After that, you can showcase your presentation to friends or colleagues. Finally, give a presentation.

Week Seven: Putting It All Together

Even if we’ve made progress and our levels of anxiety and depression are now lower thanks to the above. We can return to our initial state if we’re not careful.

Week seven is about preparing for the future and ensuring that you’ll continue to do what works best.

Here’s what to do:

• What activities work best for you? List the activities that are making you feel good. Tasks that are important for your well-being.
• How to ensure you’ll keep doing them? Think about how you can keep doing these things. Set reminders. Make sure they are a permanent part of your daily life. Exercising shouldn’t be something you do only for a couple of months. It should be part of your life.
• Solving future challenges in advance: The best way to ensure that you won’t face depression – or at least won’t be completely immobilized by it – is to prepare for the worst that might happen. Think about future challenges that might arise. What tools and mental techniques you can adopt to overcome these challenges?

“No matter how much work we put into a CBT program, none of us meets our goals perfectly or feels like “the work is done.” In what areas do you want to continue making changes?” Seth J. Gillihan

Actionable Notes:

• Basic human needs: Commonly we think that we need things – material possessions – to feel satisfied but the truth is slightly different. The author identifies three aspects that are essential in order to feel psychologically fulfilled: 1) Autonomy – the ability to do what you want to do; 2) Relatedness: Meaningful relationships with fellow humans; 3) Competence: Putting our talents to use. The closer we get to these three, the better we’ll feel.
• Logging your time: A large part of understanding how you are performing in your life is figuring out what you’re actually doing throughout your days. Think about: What type of activities feel pleasant and which ones feel harmful? For this purpose, the author suggests keeping a daily journal where you record your activities per hour. Simply put, you record what you’re doing for each hour of the day, and you rate your overall mood for each activity on a scale from 0 to 10. Plus, how important is this activity – again, from 0 to 10. For example, you can write: Time: 08:00 – 09:00; Activity: Exercise; Enjoyment: 5; Importance: 9.
• Prepare for the worst: A lot of times, success is anticipating what can prevent you from doing something and preparing in advance for the worst. The author shares the story of Ulysses from the epic poem The Odyssey. In short, Ulysses wants to hear the Sirens sing, but everyone who hears their songs ends in a devastating death. What Odyssey does is he orders his crew to bind him to the mast of the ship and instruct the men to plug their ears with wax. This way, he isn’t relying solely on his willpower. Knowing this, you can prepare in advance about what can prevent you from exercising, for example. You can schedule an appointment with a friend to meet at the gym. This will make it harder for you to bail out.
• The nuance of “I’ll try”: When you say, “I’ll try to go to the gym tomorrow.” Do you really mean it? Or do you simply hope you’ll go? There is a big difference between trying to do something and actually doing it. “Notice if you mean it in the active sense or the wanting sense,” says the author in the book. He later adds: “The more active you make your trying, the more you set yourself up to succeed.” Saying “I’ll try” without actually meaning it gives you an easy way out if you don’t do what you meant. Trying involves effort and action. Use it when you really want to try.
• Face your fears frequently: When the author prompts you to face your fears, he doesn’t want you to forcefully make you do things you’re shit-scared of. The point is to choose to face them. Then, start small. As mentioned above. If you are afraid of public speaking. Don’t sign up directly to give a TED talk. Attend a couple of meetings and give an online presentation first. The other important factor is frequency. Don’t stop doing the activity. Frequently exposing yourself to things that initially scared you will completely re-frame how you think about them. From bringing discomfort and agony. You will start seeing these activities as comfortable and actually enjoyable.

Commentary and Key Takeaway

Full of gaps to actively engage with the text. This book with the extremely long-winded title Retrain Your Brain: Cognitive Behavioral Therapy in 7 Weeks: A Workbook for Managing Depression and Anxiety by Seth J. Gillihan wants to help us take control over our emotions and not let them make us feel helpless.

What I liked about the book?

• It’s well structured.
• It offers a chance to actively engage with the text.
• The text is accessible and easy to understand.
• It clearly shows that the author wants to help us take control of our lives.

What I didn’t like about the book?

• It’s repetitive.
• The gaps that prompt you to write are, I think, frequent in order for the book to reach a certain page size.
• The text often feels like a strange mixture of a productivity planner full of general self-help advice.

Despite the above, Retrain Your Brain offers three great things. First, an excellent introduction to cognitive behavioral therapy. Second, a well-defined plan to help us fight our demons. Third, a peek behind a curtain of what therapists do in their sessions.

The book is full of talks with patients, and reading about what people struggle with helps you build resilience. Plus, it shows you that you’re not the only one possessed by damaging thoughts.

Key takeaway:

It’s not what happens to us that’s important. It’s how we interpret the event. Our thoughts influence our feelings, and our feelings control our behavior. The more we fear something. The more we’ll avoid doing it. Which further reinforces our fears and negative feelings. To escape this negative loop. We need to face our fears.

Notable Quotes:

“The key to a depression-free life is to develop healthier patterns of behavior where each day contains important and/or enjoyable activities that help you feel fulfilled and as if your life has a purpose.” Carl W. Lejuez

“Two people might experience the same event in completely different ways, depending on their interpretation.” Seth J. Gillihan

“When we’re depressed, we often see any disappointing event as evidence of our own failure. Sometimes we even turn positive events into negative ones. Depressed thinking can turn even a win into a loss. Common thoughts in depression center around themes of being “less than” in some way.” Seth J. Gillihan