Counselling & Psychotherapy in Crouch End

The answer can shape the direction of therapy. Different therapeutic approaches place emphasis on different aspects of our experience, depending on what can realistically be changed and what cannot.

Let's start with emotions. Imagine trying to feel intensely happy right now. Then, a few seconds later, trying to feel deeply sad. Then excited. Then worried. Most people quickly discover that emotions do not respond particularly well to direct commands.

Of course, we can influence how we feel. We can listen to music, watch a sad film, think about pleasant memories, or spend time with people we care about. However, these things influence emotions indirectly. We cannot simply decide to stop feeling anxious in the same way we might decide to stand up or sit down.

This is an important realisation for people who have spent months or years trying to force anxiety, sadness, or frustration to disappear. When so much attention is devoted to battling with difficult emotions, it can become harder to focus on the parts of life that are actually within our control.

Thoughts are a little different. If I ask you to picture a chair, most people can do that quite easily. If I ask you to picture a car or an elephant, you can probably bring those images to mind without too much difficulty. Compared to emotions, our thoughts are definitely more controllable.

However, thoughts are not completely under our control either. For example, try not to think about a pink elephant. Don't picture one. Don't think about not thinking about one. Don't think about one at all. Most people immediately notice a pink elephant appearing in their mind. The harder they try not to think about it, the more difficult the task becomes.

This illustrates something important. Although we can influence our thoughts to a greater extent than our emotions, we cannot completely dictate what enters our minds.

Now consider your actions by trying this experiment, raise your hand. Make a fist. Wiggle your fingers. Put your hand back down.

Most people can do these things immediately and without any difficulty. In general, our behaviour is the aspect of our experience over which we have the greatest degree of control. This leads to a useful way of thinking about psychological difficulties. Rather than seeing thoughts, feelings, and actions as equally controllable, it can be helpful to think of them as existing on a hierarchy. Emotions are often the least controllable (although sometimes the most painful to experience). Thoughts are somewhat controllable, but it is our behaviours that are usually the easiest to control.

This does not mean that all behaviours are completely controllable. I’ve spent more than 20 years working with people struggling with alcohol problems and other addictions, and I know it is not as simple as telling someone with a powerful urge to "just stop".

Nonetheless, particularly in anxiety disorders, it is important to recognise that behaviour is often the place where we have the most influence. We may not be able to choose what we think or feel in a given moment, but we usually have more control over what we do next.

Many people get stuck because they focus most of their energy on trying to control what is least controllable. They tell themselves that they will attend the social event when they feel confident, apply for the job when they feel less anxious, or make changes to their life when they feel more motivated. Unfortunately, emotions rarely work to our timetable, and this is doubly so for the kind of people that see out help from me.

A different approach is to focus more attention on what we can directly influence. We may not be able to choose whether anxiety appears, but we can choose how we respond to it. We may not be able to stop every negative thought from entering our minds, but we can decide what actions we take next. This does not mean that thoughts and feelings are unimportant. Far from it. However, many people find that their emotional lives begin to change when they stop fighting so hard to control every thought and feeling, and instead focus on taking meaningful action.

In future articles, I'll explore why attempts to control difficult thoughts and feelings can sometimes make emotional struggles worse, and why modern behavioural approaches increasingly encourage us to focus on our actions rather than getting caught in battles with our inner experiences.