With a name like “Cognitive Therapy for Women”, it may come as no surprise that our practice’s treatment model places a heavy emphasis on understanding, examining, and adjusting thoughts (or cognitions) that undermine our patients’ well-being. And while it’s true that our mind plays a critical role in determining how we function in the world, there are some moments when accessing our “higher order” or “top-down processing-based” coping techniques evades even the most CBT-proficient among us. Whereas “top-down” processing skills focus on what our mind is doing and how our thoughts affect the way we feel, act, etc., “bottom-up” processing involves focusing primarily on the messages our bodies are actively sending to our brains.
So what do we do when, say, our feelings of anxiety, sadness, or anger have flooded us to the point where our go-to cognitive reframing skills (e.g., “decatastrophizing,” “check the facts,” “worry time,” etc.) have floated too far away to be reached? In moments like these, our “bottom-up processing” skills can be immensely valuable. Put simply, these techniques make use of bodily “data” as their primary reference.
At this point you might be asking yourself, “So what do these techniques look like in practice?” Great question! And the answer might surprise you, as you may already be aware of (or even practicing) these skills without even knowing it. For example, if you have ever taken a yoga class or listened to a mindfulness meditation where you were prompted to “focus on your breath,” “notice the sounds happening in the room around you,” or “observe the sensations in your chest, stomach, feet, etc.,” then congratulations! You have officially begun building your “bottom-up” skillset.
Now let’s talk about some of the things that make these “bottom up” techniques so uniquely beneficial compared to their cognitive counterparts. For one thing, they arguably don’t require us to use as much of our mental “bandwidth” up top (no pun intended). In other words, even when our internal resources are being depleted by intense or even overwhelming emotions, we will usually have enough of those resources left over to “drop anchor” in our own bodies and simply observe whatever physical sensations are already there.
Let’s say you have an intense fear of flying- a fear that at times even turns into actual moments of panic. When you are in that panicked state, strapped into your cramped airplane seat and desperate to get back on land, which of these actions seems more feasible to take as as first step:
Planting your feet on the ground and wiggling your toes to see how they feel inside your shoes?
Or
Asking yourself “what worst case scenario am I imagining right now, what is the likelihood probability that this worst fear of mine will come true, and what could I do to cope if it did?”
For those of you that picked the second choice, good news! Your “top-down” coping skills are already accessible and ready to go to work for you. And there is good news for those who picked the first choice as well: these cognitive skills are still in your proverbial “toolkit.” The only difference is that in order to make use of them, we must first help you dial down the intensity of the panic that is temporarily holding them out of reach.
Here is where your toes come in. Your toes, your nose, your hands, your eyes- your choice! Pick a part and there’s your start. For this example though, let’s stick with your toes. By simply tapping into the basic, tactile sensation of your toes as they make contact with your shoes, and your shoes as they make contact with the floor in front of you, you are providing your body the resources it needs in order to transmit an “all clear, nothing to fear” message to your mind. In other words, once your body has made your mind aware of the fact that your feet are resting on an intact floor and not, say, dangling in the mouth of burning airplane wreckage, it is going to be a lot harder for that same mind to convince you that you’re in danger.
Once your toes have succeeded in making your mind aware of the fact that you are in safe surroundings and are not under any active threat, you might then observe that other parts of your body are starting to respond in kind. Perhaps your heart rate has started to drop from a state of “pounding panic” to “trepidatious ticking.” In simply noticing this change, you have once more utilized the help of your “bottom-up” processing skills; whereas earlier your feet sent messages to your mind about the safety of your surroundings, this time, your heart has communicated that it no longer feels the need to pump excess blood through your body in order to ready itself for a fight. All the more comforting data for your mind to be reassured by!
Whether we’re starting from bottom up or top down, your CTW therapist is here to help you access and harness your power to respond to your emotions. Reach out to us and get started today!