Question: I am a young adult with anxiety and constantly beat myself with mistakes that I make. I was wondering if you can please give me insight on how to deal with it. I'm a bit impulsive. For example, I spent a bit too much on food recently and now I'm upset that I don't have any money left for more important things I need. I think very bad thoughts that are not letting me move on in life. I get very tense and have negative thoughts of “you did a terrible thing”. Are there any tools that might help me? Thank you.

It is encouraging to read about your insight and determination to work through your challenges. Regular psychotherapy would probably be beneficial to appropriately work through your anxiety, guilt, and impulsivity. Although there may be several effective ways to tackle your challenges, I typically utilize a behavioral psychotherapy approach, incorporating elements from CBT (cognitive-behavioral therapy) and DBT (dialectical behavior therapy). A part of this approach involves conducting a thorough behavior analysis, which I will briefly summarize below. 

Our struggles typically involve experiencing a combination of thoughts, feelings, and behaviors that are both unproductive and detrimental. For you, specific situations such as shopping in certain stores bring on thoughts, which trigger cravings, causing you to engage in behaviors such as overspending, which then trigger guilt feelings. This can turn into a continuous cycle. While it may initially seem that we are creatures of habit and stuck in these cycles, this is not the case. There are proven methods to intervene at various points in the cycle and change its course. The central idea of this is to conduct an analysis, which will help you figure out your triggers for your guilt feelings and impulsive behavior and then learn how to replace unproductive behaviors with better ones. To make best use of this behavior analysis, it is best to write the steps down. This will both make it feel more real and help you notice trends over time.

 The first step in this behavior analysis is to take any episode of concern and describe clearly and specifically the behavior you’re trying to fix. For example, “I went to Seasons, planning on buying about $100 worth of ingredients for Shabbos, but ended up with a $450 bill”. You should then should try to detect the factors that prompted this behavior. Although you may feel that it wasn’t caused by anything in particular, try to think about what may have caused it to happen on that particular day. What were you thinking before you went on this shopping trip? What took place right before it? Were you tired, hungry, or sick during this time? Had something stressful happened to you right before?

Once you have discovered the events that prompted the behavior, try to describe in detail the chain of events that connected these prompting events to the behavior. These may include things you did, things you felt in your body, your thoughts, your emotions, or events in the environment. This is where having a therapist helps. If you’re doing this on your own you will have to be very careful to make sure each item follows logically from the previous item and you aren’t leaving anything out. You also want to describe all the consequences of your behavior. Be sure to include both positive and negative, short-term and long-term, and on you and on others. The guilt feelings that you mention are an example of a consequence, but there may be positive consequences too.

Once this is all fleshed out, you want to go back to this chain of events. For each step in the process, try to figure out how you may have handled it more effectively. This could be either something intuitive or a new skill. For instance, you could say “when I passed the aisle with the expensive meats, I could have been on the phone with my friend who could have coached me through it or I could have purposely avoided that aisle.” If hunger was a trigger, you could say, “next time when I go shopping, I will make sure to eat beforehand.” You also want to consider how you can repair the consequences of your behavior. If you harmed someone, is there a way to fix it? If you felt too guilty and berated yourself, try to focus on making things better for the next time and utilize distraction skills when you are feeling down about yourself.

May you have much hatzlacha in following through with behavior analysis and/or with the many strategies available to assist you.

Originally appeared in Yated Neeman