Core Beliefs: Addressing Despair Through CBT Part 3
"I can't do this," I thought, as I lifted the shovel, trying as best I could to clear our driveway from the twelve inches of winter snow dumped the night before. I looked at my throbbing feet, stuffed in my boots like aggravated passengers in an overcrowded bus, and sat down on the hard and cold ground. Lowering my face into sore and swollen hands, I heard the white flakes softly accumulating around me. "How will we survive?" I thought in desperation, wondering if I could afford to hire help. Just as I stood back up and grasped the shovel, intent on getting the job done despite the pain, my hands surged into powerful cramps, my fingers twisting into painful contortions. Dropping the shovel and collapsing to my knees in anguish, I began to straighten my hands against my leg, slowly feeling the muscles relax. I surveyed the remaining snow on the driveway and decks, stared up at the cloudy winter sky, and muttered under my breath, "I can't do anything anymore. I'm worthless now."
In the first article of this series, I discussed some of the fallacious thinking I have made in my assessments of my life with RA. In the second article, I talked about automatic thoughts; the quick and immediate negative thoughts that enter my mind. A third concept of CBT I have found helpful is called "core beliefs," which is the subject of this article. Core beliefs are the way we view ourselves, or who we are. They are built from our life's experiences, whether single occurrences, or long involvements, and they tend to come in the grammatical form of "I am (x)."
In the story illustrated above, my inability to shovel snow showed a core belief that "I'm worthless." Before RA, I had been making a living with my athletic abilities. For more than twenty years, whether through acrobatics, racing bicycles, or coaching others, my daily life involved rigorous and demanding exercise. RA has changed what I am capable of, though some days are worse than others. The realization that I could not do something as simple as shovel snow, a task I used to do easily, was another blow in a long line of defeats, and not a single instance of RA induced frustration.
From a CBT perspective, there is an association in my core beliefs between my physical ability and my personal worth. This is understandable if one knows my past. The culture I was raised in teaches young men that they must be physically strong to be considered masculine and desirable, and I internalized that notion. In addition, competition requires an athlete to be constantly striving; one win is never good enough. A success must always be followed by something more difficult or daring. These beliefs, that my physical talent and ability determine my personal worth, that I must be physically strong to be desirable, and that I must continue to push myself and achieve new things, don't get along with RA. Such schemas have caused me a great deal of difficulty in accepting new limitations.
I have found it helpful to reframe this, first by abandoning the beliefs I listed above. One way is to challenge the beliefs, and to find counter arguments that show a more complete picture. For instance, I can challenge the idea that physical ability and personal worth are synonymous by looking at some of the people I admire. Many of them are not athletes, but intellectuals, scientists, authors, and professionals in various careers. The value I see in them has nothing to do with physical ability, so why do I apply different rules to myself? I can also challenge the belief that I will be desirable to my partner only if I am physically strong. I can look at what I bring to our family and the life we have built together. Much of what I bring is not related to my physical condition, though some is. The important part is to see the whole puzzle, and not overly focus on a single piece. I can also challenge the idea that I must constantly strive for something bigger. For instance, I can think, "my past accomplishments are good enough, and I'm proud of them, now I've got new challenges." Besides, never being satisfied with myself sounds like a ruthless way to live.
Another helpful way I have found to reframe negative core beliefs is to imagine explaining my most positive attributes to someone, like in an interview where I am trying to look my best. Imagine the interviewer asking "how has RA changed you as a person?" I would reply, "Because of RA, I am resilient. I can smile when things are tough. I can hope when it seems like there isn't any. I am compassionate towards others. I appreciate things I didn't before. I have a deep sense of gratitude. I enjoy the good times, and I don't let minor things get in the way of the big picture." This is certainly a better response than "I am worthless!" It helps me see that though there are many negatives to RA, there are some things I have learned that are positive as well.
Most of us don't come with a button that we can push to delete the past and its powerful influence over us. Changing these types of beliefs is hard at first, but with persistence it gets easier. When I reframe negative core beliefs I have developed because of the disease, I feel mentally more capable of dealing with the pain, frustration, and difficulty that comes with it.
On a scale of 1(low) to 5(high), how difficult is it for you to talk about having RA?