I think the best psychotherapy and well being programmes have common sense overflowing from each practice, intervention or tool. Would your Gran have told you to do this when you were a child? Did the Greeks, Stoics and indigenous cultures do these things either consciously or as part of ‘the Good Life’? If the answer is an unequivocal yes then it’s definitely worth exploring. Behavioural Activation (BA) is certainly one of these common-sense tools. When we feel depressed or anxious we tend to isolate ourselves, stop doing things that make life meaningful and ruminate on our suffering. BA teaches us to challenge this by doing the opposite, making a list of varied activities to nourish our brains and recover our moods. Its not easy when you are depressed but it makes sense.
Mindfulness Based Cognitive Therapy (MBCT) was primarily developed for maintaining recovery from depression. Its creators had previously been experts in Cognitive Therapy and mixed elements of this with mindfulness in MBCT. One aspect was BA and they titled the session that focuses on it ‘How Can I Best Take Care of Myself’ to reflect the compassion embodied in Jon Kabat-Zinn’s original formulation of Mindfulness Based Stress Reduction.
BA came from the behavioural tradition of psychology, and holds that depression stems from a lack of positive environmental factors and/or too many punishing factors. There are different varying approaches to BA, often they start with an analysis of how you are spending your time hour by hour each day. How do these activities impact your emotions and moods? Then identifying positive experiences to add in and negative experiences to remove. This is followed with tracking the impact on your mood of increasing these positive steps and reducing negative factors. In MBCT we identify positive events by two categories: pleasure activities and mastery activities. Pleasure activities are inherently rewarding and involve enjoyment like talking with a close friend, eating nourishing food, listening to beautiful music etc. Mastery exercises give us a sense of satisfaction through mastery of our environment, like tidying our house, planning our monthly spending etc. Of course, there can be some overlap between pleasure and mastery, but it is good to schedule a balance of these activities.
It sounds very simple, but this can be a herculean task when you are depressed. When the weighted shirt of depression is on you, it can be a huge task just getting out of bed. You can’t think straight, your own mind is attacking you with the weapons of doubt, self-criticism and meaninglessness. So how can you use BA to move through the quicksand of depression or the paralysis of anxiety? In the next article I will explore some ideas that have helped me when using BA to work with my own anxiety and depression.