Not one, not two, but three separate sessions inspired today’s blog. It can feel like a strange day at the office when the same topic reoccurs multiple times throughout the day or the same work week. And that is what I encountered yet again. Occasionally at a week’s close, I will spend a few minutes slowly slipping into wandering thoughts about reoccurring themes from sessions, implications for patient care, and mapping areas to explore in future visits. In doing so, a recollection of a metaphor used during a quick intervention of psychoeducation came rushing back to the forefront. Mental wellness (health) can be best illustrated in the same likeness as physical exercise for the human body. A healthy body is one that is both strong (operationally defined as able to withstand impact without compromising function) and flexible (dexterity to minimize the risk of injury). A healthy mind is one that is both able to withstand impact/ trauma and is also flexible (able to adapt to change).
The greater a mind can be flexible, adaptable, and dexterous in adverse conditions (experiences, emotions, etc), the greater the likelihood is that the mind—the person—can cope in stressful or unknown conditions. Change or uncertainty can elicit a host of emotional and somatic sensations for people. A person’s willingness to welcome new or alternative information in these moments of change or uncertainty are often qualities, I observe in session, to gauge a patient’s readiness for specific interventions, how well they may be coping outside of the session room, or their awareness of their own accountability to coping in such experiences. This can be helpful in moments where frustration, defensiveness, or dissatisfaction are vocalized, when things do not go as planned, or when patients are not feeling “better” when they may perceive they should be because they are attending psychotherapy. The ask here on an individual level is how rigid or inflexible are your beliefs, attitudes, or behaviors when you do not know, are doubtful, distrustful, or scared? And if what you are doing is ‘not working,’ what is the threshold of time it may take you to let go of your fixed thoughts, judgments, or behaviors and grant yourself permission to consider possibilities beyond what you ordinarily would consider? Here is where cognitive flexibility as an intervention can be a great tool to employ when coping with change, uncertainty, or doubt. If you tend to be quite flexible and experimental already, do you trust your own recommendations or appraise others’ suggestions as more reliable than your own?
Typically, an overarching goal for patients is never absolute thinking—it must be this way or that; but for each patient to find greyness (middle-ground) between the two options they see. Envision a line graph with two polar choices on opposite ends. These points to not represent the most extreme choices but may represent a concrete way to visually see space between the two you have identified and help create alternatives that may exist closer to one point but not as extreme as the polar choice. Once options are developed, weight the role of ‘risk-taking’ in building your internal resource (coping) when you test alternative beliefs, attitudes, or behaviors than you would normally. Sure, the outcome may not always be favorable however rest your attention on the reason for the exercise—building flexibility in your thinking—so that you are able to adapt to changes known or unknown. With trust in your own intuition and repetition, challenging your own thoughts/ attitudes, cognitive restructuring, reality testing and calculated risk-cognitive flexibility can be developed for anyone—within limits (for persons with preexisting conditions affecting executive functioning).
As a disclaimer, blog posts do not act as clinical recommendations outside of the counseling room. For non-patients, blog posts act as supportive self-help. Like and share!

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