How People Maintain Mental Problems

Posted on June 5th, 2013

Photo by Marty.FM

Your thoughts, beliefs and interpretations about yourself, and situations in which you find yourself in have a strong influence on your emotional reactions and behavior. Sometimes, thoughts and beliefs can become negative and grow out of proportion. If they are maintained long enough, they can eventually turn into mental health problems such as social anxiety, depression, and fears. If you want to understand and change how you think, feel, and behave, you have to become aware of these five principles:1

  1. The cognitive principle: Your interpretations of events are more important than the events themselves.

  2. The behavioral principle: What you do has a strong influence on your thoughts and emotions.

  3. The continuum principle: Mental-health problems can occur when normal processes (thoughts, beliefs, behaviors) get blown out of proportion. In other words, smile things are magnified to the point of huge problems.

  4. The here-and-now principle: If you want to change things, you have to realize that what happens inside your head now is more important than searching for cause of the problem.

  5. The interacting-systems principle: Almost any problem you have should be examined as interactions between your thoughts, emotions, behavior and physiology and the environment in which you live.

Once you become aware of the above five principles, you can look at the common patterns of how people maintain their problems and see if you can spot your own problem thoughts, beliefs, or behaviors.

Safety Behaviors

Anxious people often take steps to do something which they believe protects them from whatever threat it is that they fear. For example, a man who comes across a friend standing in the street waving his arms up and down. When he asks the friend what he is doing, the answer is, “Keeping the dragons away.” “But there are no dragons around here,” the man replies. To which his friend says, “See, that’s how well it works!”

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Escape/Avoidance Behavior

Avoidance (or escape) is a common form of safety behavior. Avoidance does not necessarily mean running away when you meet an anxiety-provoking situation. For instance, someone who gets anxious in social situations might say that he does not avoid such situations but when he actually talks to people, he never looks them in the eyes, or he never talks about himself.

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Reduction of Activity

Reduction of activity is a very common in people with depression. Depressed mood leads to reduced activity, which then leads to the loss of most activities that used to bring positive feelings, a sense ofachievement or social acceptance. Lack of positive rewards in turn maintains low mood.

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Catastrophic Misinterpretation

Catastrophic misinterpretation for people with panic disorder, health anxiety or obsessive compulsive disorder (OCD). Changes in the body or in thoughts can produce symptoms similar to anxiety. For example, increased heart rate (running, swimming), breathing difficulties or other signs of autonomic arousal can be interpreted as an immediate and serious threat. A person might think that “I am about to have a heart attack”, or a “stroke”, or that “I am going mad”.

These kind of thoughts can cause even more anxiety and more symptoms, which will indeed confirm the original thought. Thus, a person becomes sucked into the viscous cycle of mind-body symptoms.

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Scanning or Hypervigilance

This process is common in people who have health anxiety. Worrying that you might have a serious health problem can lead to increased scanning or checking for symptoms that you believe indicate that problem. The more concerned you become about a possible health problem, the more attention you pay to the small symptoms in the body, which are actually perfectly normal.

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Self-fulfilling Prophesies

Self-fulfilling prophesies occur when people with negative beliefs about other people’s attitudes towards them may elicit reactions that appear to confirm those beliefs. For example, people with social anxiety have an expectation of being rejected by others, which leads to withdrawing from social interactions. They decline invitations to social events ore refuse to join a conversation. If this kind of behavior is maintained over a long period of time, other people will respond accordingly and the self-fulfilling prophesy will become true.

Another example is a person who has a conscious or unconscious expectation of other people being hostile. To protect himself from possible hostility a person displays aggressive behavior “If you intimidate me, I’ll kick your ass”. This aggressive behavior may actually elicit a hostile behavior from other people as a natural response. This expectation of hostile behavior from other people will confirm one’s prediction of hostility.

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Performance Anxiety

This pattern is common in people with social anxiety. Worrying that you might not perform “adequately”, talk coherently, or maintain an erection, leads to anxiety, which can indeed influence your performance in a negative way because you begin to consciously interrupt normal thought processes. This interruption can lead to hesitant speech, signs of nervousness, erectile difficulties, and other problems. Experience of these symptoms strengthens the negative beliefs about performance.

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Fear of Fear

Although it sounds simple, this can actually be a serious problem. The experience of anxiety itself can become so strong that a person might develop a fear of anticipating becoming anxious again. This fear can produce the actual anxiety that a person is so afraid of.

Often, people with this problem have a hard time identifying what actually causes their fear and the only things that they can say about their problem is that they find the anxiety intolerable. However, with proper psychotherapeutic approach, it is possible to find an external feared consequences, which can be used as a starting point for resolving the problem.

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People with negative beliefs about their own self-esteem and who strive for perfectionism, have the desire to prove themselves not completely worthless or incapable. These people set such high standards that it becomes practically impossible to meet these standards consistently. As a result, their low self-esteem is maintained rather than improved.

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Short-Term Reward

Short-term reward occurs when the behavior is maintained by rewarding short-term consequences, even though this behavior leads to negative longer-term consequences. From the evolutionary perspective, short-term rewards or consequences are more desirable than the long-term ones. Some examples of short-term rewards include substance abuse, some forms of eating disorder, aggressive behavior, escape and avoidance behavior and other behaviors. However, these patterns of behavior are not universal laws but rather examples that can help you reflect on your own behavior.

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  1. Westbrook, D. E., Kennerley, H., & Kirk, J. (2011). An introduction to cognitive behaviour therapy: skills and applications (2nd ed.). Los Angeles: SAGE. 

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