Behavioral Activation: How To Be More Active in Your Life!

[Daniel E.]

How to Be More Active in Your Life!
by Matthew Tull, PhD, About.com

When people feel depressed or anxious, they may be less likely to do the things they enjoy, and therefore, it is important to learn how to be more active. Behavioral activation is a way to do this. The goal of behavioral activation is simple. It helps people get more active in areas of their life that are pleasurable and enjoyable. Being more connected and involved with these experiences can improve your mood.

Behavioral activation is easy. Follow the steps below to identify the goals and activities you want to accomplish so you can get started on your new, more active and positive lifestyle as soon as possible.

Difficulty: Easy
Time Required: It is completely up to you!

Here's How:
Identify your goals. Come up with a list of several short- and long-term goals that you would like to accomplish. These goals can have a definite end-point (for example, getting a new job) or may be never-ending (for example, being a more giving person).

Next, identify smaller activities that you can complete each week that are going to take you closer to the goals that you identify. For example, if you want to be a more giving person, you might want to choose an activity that involves volunteer work or giving to a charity.

On a sheet of paper, write down all the activities you want to complete for a certain week. Also indicate how many times you want to do the activity and for how long. For example, someone who writes down exercise as an activity may also write down that they want to exercise three times a week for at least half an hour.

Each day, track your progress. When you have completed a goal for that week, place a checkmark next to the activity to indicate its completion.

If you complete all your goals for a certain week, reward yourself. Give yourself credit for being more active and getting closer to meeting your life goals.

Each week, build upon the previous week. Carry activities over from week to week. If there are certain activities that you want to make into a habit (for example, weekly exercise), repetition is important.

Enjoy your new, more active and enjoyable lifestyle!

Tips:
When coming up with goals and activities, variety is key. Choose goals and activities from a number of different life areas, such as those that involve relationships, education, career, hobbies, spirituality, health.

The purpose of behavioral activation is to improve your mood, not stress you out even more. Come up with activities that you find enjoyable. Also, start out slow. In the first couple weeks, come up with a list of activities that you know you can easily accomplish and then slowly build from there. Coming up with too many activities in the first week can be challenging and stressful, making it less likely that you will meet your goals.

Track your progress. If you decide to use a form to keep track of your goals, hold onto forms from weeks past. Each month, review the progress you have made in getting closer to reaching your goals.

Finally, commit to completing the activities you choose from week to week. However, it is important to remember that there are going to be times when other pressing needs take precedence over these activities. If you find that you are unable to complete your goals for a certain week, take a look back at the week and identify any obstacles that prevented you from doing so. Problem-solve how to side-step those obstacles next time they present themselves.

Related video:


Related articles:
Behavioral Activation - About.com
Behavioral Activation - Wikipedia
Just Doing it: Behavioral Activation
Behavioral Activation - Clinical Handbook of Psychological Disorders

Worksheets:
Overcoming Depression One Step at a Time: The New Behavioral Activation Approach to Getting Your Life Back
www.cci.health.wa.gov.au/docs/WS-Behavioural Activation.pdf
BATD Manual, Revised (in appendix)

 

[Daniel E.]

Regarding motivation:

[Behavioral activation] targets inertia. When depression zaps motivation, the BA [behavioral activation] approach is to work from the "outside-in", scheduling activities and using graded task assignments to allow the client to slowly begin to increase their chance of having activity positively reinforced.

Christopher Martell :: Behavioral Activation Therapy

http://forum.psychlinks.ca/coping-strategies/18168-why-motivation-doesn-t-really-matter.html

 

[Daniel E.]

Preparing for Change

• Keep a curious and open mind about the changes you are making.
• Treat changes in your behavior as experiments from which you can learn rather than as tests of your willpower or self-worth.
• To maximize the likelihood of success, choose new behaviors that are manageable.​
• Don't take on too much at once or raise your expectations too high.
• Separate the process of making changes into steps.
• Avoid criticizing, shaming, or blaming yourself as you make changes.
• "Just do it" doesn't work. If change were that easy, you would have done it by now.

Coping with Difficult Feelings

Feeling | How to Cope
Overwhelmed | Break a task down into smaller components.
Fearful | Do the least frightening steps first and move up a hierarchy to the scarier steps.
Bored | Make the situation more interesting externally (play music you like, etc.)
Tired | Reward yourself frequently during a boring or tiring task. Take breaks.
Angry | Relax and concentrate on something that you're not as frustrated with.
Sad | Allow yourself to feel the sadness for a while. There is no reason to stifle it, especially if you are grieving over a loss. When you feel sad all of the time, however, try to let it go...

Source: Overcoming Depression One Step At A Time

 

[Daniel E.]

What about trauma and loss?

Often when people have experienced traumatic events and loss, negative thoughts and feelings about the event come to mind all the time. It becomes hard not to think about it or feel terrible that it happened. We find that it is important to understand how these experiences impact your current behavior. For example, you might find it difficult to sleep at night, and so you spend a lot of time sleeping during the day. If you sleep during the day, you may be unable to perform important daily activities or lack the energy and desire to socialize with family and friends. This treatment [behavioral activation therapy] will help you to identify activities that might be making your depression worse, and can help you modify or change those activities so that you feel depressed less often. The goal of this treatment is to help you make the best life possible for yourself. This can be hard work, but if you trust the process you will find that good things will come from your effort.

Source: Brief Behavioral Activation Treatment for Depression Manual, Revised

 

[Daniel E.]

Beliefs that Prevent Engagement in Positive Experiences

• "Why should I do anything? I'll just feel bad again afterward."
• "I've tried doing stuff I used to like. It just doesn't feel the same as it used to."
• "I can't think of anything fun to do."
• "I don't have the energy. I would just go through the motions, and that's no fun."

Guidelines for Increasing Positive Emotional Experiences

1. Pay attention to the activity. Be mindful. Watch each element of what is going on like you have never experienced it before.
2. Be engaged. Acitvely participate. Let other thoughts and ideas that are not related to what you are doing fade away. Focus your energy and concentration on the enjoyable moment.
3. Pay attention to the now. Don't think about when it will end or how long it will last.
4. Pay attention to the feelings in the moment. Don't compare them to previous feelings, anticipated feelings, or ideas about how others might feel when they are engaged in the activity.
5. Don't wait for a particular level of satisfaction or enjoyment to appear before you further engage in the activity. Be mindful of the now.

Source: Depressed and Anxious: The Dialectical Behavior Therapy Workbook for Overcoming Depression & Anxiety

 

[Daniel E.]

Interventions for Ruminative Thinking

Highlighting the consequences of ruminating

• Ask yourself: How does ruminating affect my mood? Is it useful to ruminate? Does it help me to solve a problem in any way? Does it have short-term or long-term benefits (e.g., reducing an aversive experience such as sadness) or costs?

Problem solving

• Define a concrete problem to be solved; generate and evaluate possible solutions; identify the steps to help experiment with change; put the steps into action; review the results and troubleshoot.

Attending closely to sensory experience

• Direct your attention repeatedly to the sensory experience of seeing, hearing, smelling, touching, or tasting in the moment.

Refocusing on the task at hand

• Identify what specific steps are needed to complete a task. Bring your attention back to one step at a time.

Distracting oneself from the ruminative thoughts

• Direct your attention repeatedly to a focus that distracts from ruminative thoughts. Do something active with your body (e.g., play with a pet, exercise) or with your mind (e.g., sing a song, go through the alphabet and list objects beginning with each letter).

Source: Handouts from the book Behavioral Activation for Depression: A Clinician's Guide:

 

[Daniel E.]

The ACTION Acronym

Through these ACTION steps, therapists can remind clients of the key components of BA [behavioral activation]: to evaluate the function of their behavior, to identify when they are engaging in avoidance behavior, to remember that they have a choice in how they respond to situations, to integrate new behaviors into routines, to observe and learn from the outcomes, and to persevere with the process of change.

Assess the function of a behavior. In other words, the client asks him- or herself how the behavior is serving him or her. What are the consequences? Does the behavior act as a depressant? Is it inconsistent with long-term goals? Does the behavior act as an antidepressant? Is it consistent with long-term goals?

Choose an action. The concept of choice is important for two reasons. First, BA is a collaborative treatment. Clients and therapists work together as partners. Clients maintain a choice over the actions that they implement. Second, many depressed clients do not have a sense of personal agency or control in their own lives. Explicitly pointing out that they have a choice highlights their ability to exert control and influence in their lives. Clients can choose to increase or decrease specific behaviors.

Try the behavior chosen. Putting the plan into action is the heart of BA.

Integrate new behaviors into a routine. This is an essential idea to get across. After months or even years of depression, one instance of activating may not have a strong impact. Trying a new behavior just once is not sufficient for evaluating outcome. The cumulative effect of working from the “outside-in” and increasing activity is important. Repeatedly activating as new behaviors are integrated into routines can lead to improvement in mood and life context.

Observe the results. The hope, of course, is that integrating antidepressant behavior into a routine will improve the client’s depression. We cannot know if this will be the case until the client has scheduled activities, chosen to engage, and then, after integrating the activities over several trials, we and the client observed what happens. Observing the results, learning from what worked and what didn’t, and using this information to improve future action plans are all key parts of BA.

Never give up. In other words, keep going through this process. Developing a new habit of activating and engaging requires repeated efforts. Over time, these antidepressant behaviors can become automatic, even amid overwhelmingly negative feelings.

Source: Handouts from the book Behavioral Activation for Depression: A Clinician's Guide.

 

[Daniel E.]

Notebook and Weekly Therapy Plan

These sheets can be used during your therapy or as a means of self-help to continue when therapy is completed.

• What problems were discussed today in therapy?
• What have I learned about the connections between how I feel and the activities in which I’m engaged?
• What behaviors do I need to increase that are antidepressant for me?
• When will I engage in these behaviors?
• Have I broken these behaviors into steps that I’m likely to complete? If so, what are the steps?
• What activities have a good chance of being powerful enough for me to lose myself in?
• Are there any activities that I’m trying to escape or avoid?
• Are there any behaviors I need to decrease because they act as a depressant for me and are inconsistent with my long-term goals?
• To what stimuli or activities can I attend so as not to be stuck in my head?
• Where am I likely to have a particularly hard time?
• What can I do to make it likely that I’ll be able to cope?

Source: Handouts from the book Behavioral Activation for Depression: A Clinician's Guide.

 

[Daniel E.]

RCA: Rumination Cues Action

This may seem like a strange idea, but you can actually teach yourself to use ruminating as a cue to get active. You can use the acronym RCA, which stands for "rumination cues action." A cue is something that prompts you to be behave in a certain way. For example, a red stop sign...Unfortunately, if you tend to ruminate, then many things in your life probably cue you to do so. And, ruminating itself has probably become a cue for more ruminating. But that can change...

Over the next few days, try to put this RCA process to work. Whenever you observe yourself ruminating, label it ("This is ruminating"), and then use it as a cue to shift to a different activity. If you stick with it for a few days, you should notice a major decrease in the amount of time you spend ruminating, and your mood should improve.

Source: Overcoming Depression One Step At A Time: The New Behavioral Activation Approach to Getting Your Life Back

 

[Daniel E.]

How Thinking Can Be Problematic Behavior

The process of ruminating keeps clients stuck in negative states and almost invariably results in disengagement from the environment. This assessment is consistent with the formulations of Lewinsohn (2001), who proposed that depression elicits a focus on the self that is repetitive but doesn't lead to problem solving. Clients can become caught in mental ruts, thinking, for example, "I feel down today—why does this keep happening to me? Will I ever beat this? This is just too hard." Such thoughts rarely have end points, they do not lead to effective problem solving, and the thoughts recur repeatedly. The consequence is a self-perpetuating process that keeps the individual stuck in his or her thoughts, less likely to find a positive, active solution, and more likely to be disengaged from other activities. Such sustained focus on internal feeling states may decrease any pleasure that can be derived from activities and may perpetuate depression by preventing goal attainment.

Source: Behavioral Activation for Depression: A Clinician's Guide

 

[Daniel E.]

Challenging Your Lack of Motivation
by Robert L. Leahy, PhD

• Don't wait for motivation to show up. Action creates motivation.
• When you say you're not motivated to do something, you're really saying, "I don't want to do that." Be willing to do what you don't want to do.
• Decide what kind of person you want to be. Do you want to be someone who waits for things to happen or someone who makes things happen?
• Choose your purpose. Set specific goals you want to accomplish in the next day, week, month, and year.
• What did you do when you weren't depressed? Act against your depression by doing some of those things.
• Predict how much pleasure and effectiveness you expect to feel from a given activity. Then try it, and track the results. Test your pessimism.
• Sample your reward menu. Add the activities that yield the most pleasure and effectiveness, and then put them on your schedule.
• Examine the costs and benefits of doing things—long-term and short-term.
• Don't expect an immediate payoff. Over time, your new habits will create new realities. You can start right now.

excerpted from: Beat the Blues Before They Beat You: How to Overcome Depression

 

[busybee]

Thanks Daniel. all excellent information and as I am currently going through a very low point at this time, it helps to read information to bring back the reality of being mindful, choices and decisions that affect what I do. And not resorting to victim mentality.

Does not make the depression less... but it changes the focus.

 

[Daniel E.]

The Happiness Project: No More Complaining, "I Feel So Tired."

...This sounds like magical thinking, but hard science show that the “Fake it ‘till you feel it” strategy really works. The least productive approach is to do what I’ve been doing – dwelling on my feelings of tiredness...

 

[Daniel E.]

Insights on Insight
by Sarah Ravin, PhD

..We learn and mature emotionally through experience. Thoughts and feelings follow from behavior, not the other way around. Simply knowing why you think the way you think, or why you feel the way you feel, does not change your thoughts or feelings. What does help change your thoughts and feelings is by acting opposite to them. So, for example, if you are feeling depressed and lethargic, sitting around the house all day by yourself trying to figure out why you’re depressed doesn’t make you less depressed. However, dragging yourself off the couch to go for a brisk walk outside, and then inviting some friends over to watch a funny movie, may very well lift your spirits, at least a little bit.

Our neural pathways are rewired not through developing insight, but through consistent, repetitive practice of new behaviors. You will not become a good athlete by watching sports or reading about sports. Rather, you develop and hone your athletic skills by consistent practice and physical conditioning...

 

[Daniel E.]

from Behavioral Activation in Cognitive Behavior Therapy: Basics and Beyond
by Judith Beck, PhD

Conceptualization of Inactivity
Situation: Thinking about initiating an activity
[Common] Automatic thoughts: "I'm too tired. I won't enjoy it. My friends won't want to spend time with me. I won't be able to do it. Nothing can help me feel better." -->
[Common] Emotional reactions: Sadness, anxiety, hopelessness. -->
[Common] Behavior: Remain inactive.

Conceptualization of Lack of Mastery or Pleasure
Situation: Engaging in an activity
[Common] Automatic thoughts: “I'm doing a terrible job. I should have done this long ago. There's still so much left to do. l can't do this as well as I used to. This used to be more fun. I don’t deserve to be doing this." -->
[Common] Emotional reactions: Sadness, guilt, anger at self. -->
[Common] Behaviors: Stop the activity. Push self beyond a reasonable point. Fail to repeat this activity in the future.

 

[Daniel E.]

The No. 1 Contributor to Happiness
by Karen Salmansohn, Bouncing Back

...Psychologists suggest if you want to resiliently bounce back after a sideswiping, that you slowly increase your "internal locus of control" - the power you have to make easy, small changes. Studies even show that all you have to do is take control of a few small actions - and you'll be on your way to feeling like the master of your destiny once again...

Is an out-of-control life challenge making you feel "out of control" over your entire life? If so, stop lying around doing nothing. Stop sleeping late. Stop watching too much TV. Start recognizing that this lack of a disciplined schedule will only increase your feelings of being out of control of your life.

"For unhappy people, their time is unfilled, open, and uncommitted. They postpone things and are inefficient," says Oxford University psychologist Michael Argyle. "For happy people, time is filled and planned. They are punctual and efficient."

Today decide you will take back your autonomy by deciding to tap into your "internal locus of control!" Create three pre-set deadlines for new projects and three exciting events to be shared with loved ones. Mark them all down in your calendar. Then do these things and meet these people in a timely, efficient way. Know: Establishing pre-set deadlines -- then meeting them -- will absolutely help you once again feel like the kick-ass master of your destiny that you know you are!

 

[Daniel E.]

Why You Can?t Just Think Your Way Out Of Depression
by Clifford N. Lazarus, Ph.D. in Think Well

...I often tell my therapy clients "Your head and heart will follow your feet!" In other words, how you act (your feet) will often determine how you think (your head) and how you feel (your heart). Thus, you can't think your way out of depression, and not even the most experienced cognitive therapist can talk you out of it, but you can walk out of it. Hence, how you act can either carry you deeper into depression (and/or anxiety) or lead you out of it.

This is because there are "depressant" actions (that have neurochemically depleting effects on the brain) and "antidepressant" actions (that, like prescription antidepressants, have neurochemically replenishing effects on the brain).

Depressant actions typically include withdrawal, isolation, disconnection, general inactivity, and disengagement. Not surprisingly, antidepressant behavior usually involves participation, engagement, social involvement, physical movement, and reconnecting to activities you used to enjoy.

It might take some time to defeat depression because the idea that "the head and heart follow the feet" means that thoughts and feelings will come into alignment with action patterns but not necessarily right away. Your happier thinking and improved mood will lag behind the antidepressant actions just a bit because the slower, learning parts of the brain will need a little time to catch-up with the quickly reacting motor areas. Just be patient and let your feet walk you out of depression...

---------- Post added at 01:59 PM ---------- Previous post was at 11:20 AM ----------

Positive Activities Help to Relieve Depression - Psych Central News

...People often underestimate the long-term impact of practicing brief, positive activities, Lyubomirsky said.

For example, if a person gets 15 minutes of positive emotions from counting her blessings, she may muster the energy to attend the art class she?d long considered attending, and, while in class, might meet a friend who becomes a companion and confidant for years to come. In this way, even momentary positive feelings can build long-term social, psychological, intellectual, and physical skills and reserves...

 

[Daniel E.]

Suggestions for Exercising When It Feels Impossible
By Suzanne Phillips, Psy.D., ABPP, Healing Together for Couples

Don’t think Exercise – Think Movement with Motivation

Forget comparing yourself with the neighbor who jogs – start with a simple plan of moving, do it on your time and tie it to something you love.

• Park and Walk: If there is a store you like to shop in start your movement slowly by parking a little farther from the door each day. Plan this small but very big step, keep a tally – you will be surprised.
• Talking with A Friend: Call for someone or have someone call for you and plan to walk even for only one block. Before you start give yourself permission to stop and turn back. You are in charge.
• Choosing Support: There is power and motivation in the company of others, especially people who have an agenda similar to yours. In the case of two women who could not find a neighbor to walk with they came up with a plan of driving to each other’s neighborhood twice a week because they really wanted to talk to each other – they happened to also be walking.
• Book Worm: Walk around your yard, your block or in a safe place listening to an audio book for 10 minutes. Only listen to the audio book while walking, standing, cleaning etc.
• Re-runs Instead of Running: One man started walking on the old treadmill in the basement to watch re-runs of shows he loved- he wasn’t thinking of walking.
• The Brain on Music: Research tells us that music has a powerful impact on brain stimulation. If you love certain music let it be your road out. Put on your earphones and turn the music on and it will help you put on your sneakers, open the door and start moving. Dance, vacuum, walk, ride a stationary bike to music. Choose a track that you only allow yourself to listen to when moving.
• Visualize the Reward: I have an uncle who started walking to a bakery each morning. The whole way he visualized the muffin and coffee he planned to buy. He is still walking.

 

[Daniel E.]

Similarly:

 

[Daniel E.]

From "Have to" to "Get to"

Choose a particular task or situation in your life that feels like a burden. Try changing "have to" to "get to" and see if you get a different perspective. "Now I get to take out the garbage" just might make you feel grateful to the people who come and take it away. The more you notice what there is to be grateful for, the sooner your half-empty glass begins to look at least half-full.

Source: Awakening Joy: 10 Steps That Will Put You on the Road to Real Happiness

---------- Post added at 05:03 PM ---------- Previous post was at 01:40 PM ----------

"Iron rusts from disuse, stagnant water loses its purity, and in cold weather becomes frozen; even so does inaction sap the vigors of the mind."
? Leonardo da Vinci