Music + Mental Health #5

By James Palazzolo

A brief introduction:

Aloha to you, reader of Signal and Noise. This article is a reboot, the fifth in a series that was an ongoing column in the Phoenix New Times' music section. They aren't rigidly sequential, yet the intention is to help you build your own toolkit of effective, evidence-based skills of Cognitive Behavioral Therapy (CBT), for free.

I do recommend reading those other four also. They introduce the foundational understanding and skills that this article continues to build upon.

A bit about my experience and intentions: I've done my own CBT psychotherapy, and it saved my life. I've been helping others use CBT for the past 12 years. I've worked with more than 8,000 individuals. I am a believer that if everyone on Earth were regularly taught CBT skills from kindergarten onwards, the overlapping systems that Homo sapiens cultivate would be infinitely more effective, progressive, and sustainable.

I'm also convinced that psychotherapy is worth every penny. And what about those folks who don't have the pennies? So, I'm using a 70/30 rule here to give CBT away. CBT skills can be taught quickly, so you can begin resolving 70% of your struggles; the other 30% you'll likely need a clinically licensed guide to heal. Getting that 70% accomplished for free will save you grand amounts of loot. It will also reduce the costs of working with the licensed professional to de-escalate the more stubborn problematic aspects of your subjective existence.

My method is not unique – I borrow it from Fugazi: First, play the instrument as best as you can. Second, enforce a '$5 At The Door' method so everyone can access the content. In this instance, that $5 is $0 because the internet Cat Lords facilitate such gracious provision.

I'm also a worshipper of Euterpe, Saraswati, Benzaiten, Oshun, Merit, Marimba…. You pick. Gods of music and associated lore. As my votive, I include a 'motivational playlist' to listen to as you exercise your psyche. Your Pre-Frontal Cortex, streaming cognitions, ever-alert nervous system, emotions, mindful practices – all that internal, intra-personal territory is what I'm suggesting you attend to in a similar way to physical exercise. Bring a playlist. Invigorate a kickass mood.

We're getting into ABC Worksheets now. My strong suggestion (although it isn't a requirement) is that you know your Unhelpful Thought Patterns (UTP) and Helpful Thought Patterns (HTP) from the last column (https://www.phoenixnewtimes.com/music/phoenix-therapist-musician-has-cbt-tools-to-help-thought-patterns-22620631/). Think of this like going down a river in a canoe – it would behoove you to bring a paddle. UTP and HTP are your paddles. They will enhance the experience and deepen your insight into identifying the patterns that are creating the most stubborn interference with making change and progress.

We all struggle to think clearly when we are stressed for several reasons. At the root is stress, which most of us never learn to manage in a structured, proactive way. Stress releases cortisol. Cortisol signals the body to enter fight-or-flight mode. Read The Body Keeps the Score and The Gift of Fear for deeper dives on all that (I will write columns on stress in the future).

Front and center to help de-escalate stress are ABC Worksheets. ABC Worksheets will help you 1. Think clearly in times of stress, 2. Identify your most severe UTPs, and 3. Exponentially change your maladaptive patterns of thought/feeling/behavior into adaptive patterns that are in line with your goals. This link is a reliable source for more information and for downloading ABC worksheets.

ABC Worksheets are simple enough to understand on paper, yet they are deceptively profound in their power to permanently and positively change the way you think. There are three columns – A, then B, then C; then there are two questions – question one is the skill of Perspective Shifting. Question two is the skill of Reframing thoughts.

I'll use the example of Bob to walk through ABC Worksheets here. Bob is driving his car at 75 MPH on the highway.

In column A, the A stands for "Activating Event." This is the event that upset you. It could be an event from today, twenty years ago, or something you're concerned about in the distant or near future. Write that in this column. For Bob, it is "Someone cut me off in traffic." I like this example for an important reason – there is actual risk of harm or death, so it makes sense that Bob's Central Nervous System (CNS) goes straight to 11.

In column B, the B stands for "Belief." This is the subjective thought that went through your mind. Eventually, this column will reveal the maladaptive patterns that are holding you back from calming down, reaching your goals, and enjoying your life. Bob thinks, "Of course that happened to me… No one respects me." Not rational, right? Yes. And it tells Bob a lot about himself. And it anchors to the 'hidden' UTPs he struggles with (e.g., Personalization and Overgeneralization). You would not put "personalization" in column B – you put your subjective thought(s). Over time, you will see how your automatic subjective thought is influenced by your UTP. That's when you whack it with the HTP to take away its influence.

In column C, the C stands for "Consequences." This refers to the emotions you have in tandem with the thought in column B. Bob's feelings include fear and anger, which both make sense due to the risk of harm or death, and also irrational shame. We know this thought is triggered by his shameful thought that no one respects him, but Bob does not.

Many of us learn the alphabet in the sequence A, then B, then C. You don't have to do this worksheet in rigid order. Most folks know how they feel first. List those feelings in column C. You can start anywhere – the key is to start and remain motivated throughout the process.

Question one after columns A, B, and C is "Is the thought in column B rational and/or helpful." We already know it isn't rational (we'll get to possible rational thoughts in another article); it is also not helpful. Bob's belief that no one respects him does nothing for his self-esteem, goals, or motivation.

Question two asks, "What could I change the thought in column B to make it rational and/or* helpful?" Bob could change his thinking to, "That was scary, and it sucked. I'll slow down and get away from the driver." What we want to see happen is twofold – the thought becomes more rational and helpful, which would indicate that the 'hidden' UTP is diminished, even eradicated. Second, you want to look at column C to check whether the emotions changed or became less severe. In Bob's example, the fear and anger are de-escalating, which is great. Even better, the shame is gone. He isn't personalizing the random event.

Practice ABC Worksheets on paper for a while until you can do them in your mind. Start revealing your UTPs after you complete the full worksheet. Don't overwhelm yourself. If you begin to feel flooded by emotions, take a break. This is a marathon, not a sprint.

Here are some tunes to go with your ABC Worksheets, which put me in the mood for great covers of classic songs, which is substantially similar to changing thoughts into something new. I won't explain them. I'll let your thoughts generate the momentum.

1. Soundgarden covering The Beatles – 'Come Together'

1. Voodoo Glow Skulls covering The Beatles – 'Here Comes the Sun'

1. Cibo Matto covering Soundgarden – 'Black Hole Sun'

1. Built to Spill covering Crazy Horse and Neil Young – 'Pocahontas'

1. Jane's Addiction covering Grateful Dead – 'Ripple'

1. Bim Skala Bim covering Neil Young – 'For the Turnstiles'

1. Ween covering Led Zeppelin – 'All of My Love'

Email your questions about CBT skills to mhsignalnoise@gmail.com. *This column is meant only to educate, not to be TREATMENT. If you are struggling with mental health maladies, please either use the crisis hotline and/or contact a professional for services. AZCrisisline: 1-844-534-4673; Text: 4HOPE (44673); Chat: crisis.solari-inc.org/start-a-chat. You can research for clinically licensed psychotherapists on Psychology Today or the internet in general – just be cautious and seek out people with clinical licenses. It matters.

James Vito Palazzolo is a licensed clinical psychotherapist in AZ and OR. After 8 years working at the Phoenix VA, he has operated a private practice for the past 4 years. He works with clients on healing and personal growth subjects, including purpose, trauma, happiness, relationships, identity, control, boredom, grief/loss, addictions, and more. James is trained in Cognitive Behavioral Therapy, Cognitive Processing Therapy, Prolonged Exposure Therapy, and Dialectical Behavioral Therapy. He also formerly taught History of Rock N Roll at Penn State and plays bass/guitar/trumpet. He is a novelist, poet, screenwriter, and short story author with multiple fiction publications and a Pushcart Prize nomination.

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