SELF-HELP A N E W H A R B I N G E R S E L F - H E L P W O R K B O O K M A New We all have our own ways of handling stressful situations Approach to without letting emotions get the best of us, but some ways of coping I A work better than others. Short-term fi xes that help us avoid or numb N Single Therapy Coping with our emotions may temporarily alleviate sadness and anger, but can for Overwhelming also end up causing anxiety, depression, chronic anger, and even phys- D ANXIETY • PHOBIA ical health problems. If you struggle with overwhelming emotions and Emotions PTSD • ANGER feel trapped by unhealthy patterns, this workbook is your ticket out. a SHAME • GUILT Mind and Emotions is a revolutionary universal treatment program for all n DEPRESSION emotional disorders that helps you discover which of the seven problematic coping d styles is keeping you trapped in a cycle of emotional pain. Instead of working on diffi culties like anxiety, anger, shame, and depression one by one, you’ll treat the root of all your emo- E M i n d tional suff ering at once. Drawing on evidence-based skills from cognitive behavioral therapy, A Universal M acceptance and commitment therapy, and dialectical behavior therapy, this workbook off ers all the techniques you need to manage unwelcome feelings in eff ective and productive ways. O Treatment for LEARN and PRACTICE the T MOST EFFECTIVE COPING SKILLS: Emotional • Clarifying and acting on your core values I O a n d • Mindfulness and acceptance Disorders • Detaching from negative thoughts N • Self-soothing and relaxation exercises S • Assertiveness and interpersonal skills E m o t i o n s • Gradually facing your strong emotions Matthew McKay, PhD, is professor at the Wright Institute in Berkeley, CA, and coauthor of Th e Relaxation and Stress Reduction Workbook, Th oughts and Feelings, Self-Esteem, and many other titles. M Patrick Fanning is a professional writer in the mental health fi eld. He is coauthor of Messages, Visual- c K ization for Change, Th oughts and Feelings, Self-Esteem, and other books. a Based on Proven Techniques from COGNITIVE BEHAVIOR THERAPY, Patricia Zurita Ona, PsyD, is a clinical supervisor at the Berkeley Cognitive Behavioral Th erapy y ACCEPTANCE and COMMITMENT THERAPY, and DIALECTICAL BEHAVIOR THERAPY Clinic and the Wright Institute in Berkeley, CA. Matthew McKay, PhD Patrick Fanning | newharbingerpublications, inc. www.newharbinger.com Patricia Zurita Ona, PsyD Also available as an e-book at newharbinger.com In Mind and Emotions, Matthew McKay, Patrick Fanning, and Patricia Zurita Ona provide invaluable information for people experiencing difficulties regulating their emotions. Not only will readers learn about the factors contributing to their ongoing pain, but they’ll also learn practical skills for improving their ability to manage these intense emotions. I love the fact that these authors were able to reflect real-life psychotherapy by taking an eclectic approach to the treatment of emotion dysregulation. — Sheri Van Dijk, MSW, RSW, psychotherapist in Ontario, Canada, and author of The Dialectical Behavior Therapy Skills Workbook for Bipolar Disorder, Don’t Let Your Emotions Run Your Life for Teens, and The Bipolar Workbook for Teens This concisely written book offers well-developed, practical tools for readers intent on attending to their emo- tional needs. There is indeed a synergy in combining the best of cognitive behavioral therapy, dialectical behavior therapy, and acceptance and commitment therapy—it’s an approach that promises to help readers pursue a purposeful life. — Patricia J. Robinson, PhD, health care consultant and coauthor of The Mindfulness and Acceptance Workbook for Depression and Real Behavior Change in Primary Care Many self-help books offer tips and suggestions on how to cope with only one challenging emotion, such as anxiety or depression. Unfortunately, anxiety and depression go together, and most of us who struggle in dealing with one emotion have difficulties in managing others as well. This new and impressive workbook by McKay, Fanning, and Zurita Ona provides a welcome alternative to having to buy and follow separate books for each specific emotional difficulty you may encounter in life. Mind and Emotions will guide you through an easy-to-follow set of skills designed to put you, rather than your emotions, back in charge of your life. — Robert D. Zettle, PhD, professor of psychology at Wichita State University in Wichita, KS, and author of ACT for Depression Mind and Emotions provides a wide range of strategies and exercises for changing the behaviors and thoughts that contribute to uncomfortable feelings such as anxiety, depression, anger, and shame. This book is practical, well-written, and packed with helpful advice. — Martin M. Antony, PhD, ABPP, professor of psychology at Ryerson University in Toronto and author of The Shyness and Social Anxiety Workbook At last! Here’s your chance to clear the clutter off your shelves and get rid of all those other self-help books that don’t work. McKay, Fanning, and Zurita Ona have put together a single, effective treatment for multiple forms of emotional pain. Based on research and years of success, Mind and Emotions is sure to be the one book people will turn to for help. — Jeffrey C. Wood, PsyD, clinical psychologist, coauthor of The Dialectical Behavior Therapy Skills Workbook, and author of The Cognitive Behavioral Therapy Skills Workbook for Personality Disorders Mind and Emotions offers a clear and practical entry into the complex and often confusing world of emotions and emotional pain. The authors are experts in the field of mental health and psychotherapy, and it shows in this work. Their accessible and easy-to-follow practices will empower and promote emotional healing for anyone who takes the time to work through this excellent program. — Jeffrey Brantley, MD, consulting associate in the Duke Department of Psychiatry, author of Calming Your Anxious Mind, and coauthor of Daily Meditations for Calming Your Anxious Mind and the Five Good Minutes® series With compassion and clarity, the authors present a universal approach to the universal pain and suffering that accompanies mental health problems. Readers will find much in Mind and Emotions to calm the emotional storms that are barriers to living life fully and passionately. — Michael A. Tompkins, PhD, San Francisco Bay Area Center for Cognitive Therapy and University of California, Berkeley, and author of Digging Out This book is beautifully written in simple, clear, and precise language. In very short, highly informative chap- ters, the best-known techniques for leaning to manage painful emotions are described and then a range of concrete strategies for practicing these strategies is presented. This book can not only be used as part of a self- help program, but also as part of an emotion management skills training group or as an adjunct to individual counseling for emotion management difficulties. — Kirk Strosahl, PhD, author of Real Behavior Change in Primary Care Mind and Emotions draws thoughtfully on a transdiagnostic perspective and a triad of evidence-based treat- ments for emotional problems. Beyond its self-help value to the public, this unique workbook constitutes a rich resource for practitioners seeking to enhance their therapeutic effectiveness. — Thomas F. Cash, PhD, Professor Emeritus of Psychology at Old Dominion University and author of The Body Image Workbook The tools described in this book are drawn from the most effective therapies for emotional disorders that are available today. Used consistently, these tools can change your life. — Jacqueline B. Persons, PhD, director of the San Francisco Bay Area Center for Cognitive Therapy and clinical professor at the University of California, Berkeley M i n d A Universal Treatment for Emotional a n d Disorders E m o t i o n s Matthew McKay, PhD Patrick Fanning | Patricia Zurita Ona, PsyD New Harbinger Publications, Inc. Publisher’s Note This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering psychological, financial, legal, or other professional services. If expert assistance or counseling is needed, the services of a competent professional should be sought. Distributed in Canada by Raincoast Books Copyright © 2011 by Matthew McKay, Patrick Fanning, and Patricia Zurita Ona New Harbinger Publications, Inc. 5674 Shattuck Avenue Oakland, CA 94609 www.newharbinger.com Cover design by Amy Shoup Acquired by Catharine Meyers Edited by Jasmine Star For my students, whose desire to understand human behavior and help those in pain has inspired me and taught me so much. All Rights Reserved —MM Library of Congress Cataloging-in-Publication Data For the dedicated teachers, therapists, and researchers upon whose shoulders we stand. —PF McKay, Matthew. Mind and emotions : a universal treatment for emotional disorders / Matthew McKay, Patrick Fanning, and Patricia Zurita Ona. p. cm. Includes bibliographical references. For all those who are willing to try something new despite their pain and struggles. ISBN 978-1-60882-015-3 (pbk.) -- ISBN 978-1-60882-016-0 (pdf e-book) 1. Mindfulness-based cognitive —PZO therapy. 2. Emotion-focused therapy. 3. Emotions. I. Fanning, Patrick. II. Zurita Ona, Patricia. III. Title. RC489.M55M35 2011 616.89’1425--dc22 2011012638 For my students, whose desire to understand human behavior and help those in pain has inspired me and taught me so much. —MM For the dedicated teachers, therapists, and researchers upon whose shoulders we stand. —PF For all those who are willing to try something new despite their pain and struggles. —PZO Contents Chapter 1 The Universal Treatment 1 Chapter 2 The Nature of Emotions 11 Chapter 3 The Cost of Avoiding Emotions 25 Chapter 4 Values in Action 35 Chapter 5 Mindfulness and Emotion Awareness 47 Chapter 6 Defusion 55 Chapter 7 Cognitive Flexibility Training 69 Chapter 8 Self-Soothing 95 Midtreatment Assessment Exercise 107 Chapter 9 Doing the Opposite 111 Chapter 10 Interpersonal Effectiveness 125 Chapter 11 Imagery-Based Emotion Exposure 139 Chapter 12 Interoceptive Emotion Exposure 151 Mind and Emotions Chapter 13 Situational Emotion Exposure 163 Post-treatment Assessment Exercise 177 Chapter 14 Relapse Prevention 181 References 189 vi