Realistic Goals

This past week while doing my daily walks, I listened to lecture series on cognitive behavior therapy taught by Jason M. Satterfield, Ph.D., Professor of Clinical Medicine at the University of California, San Francisco. Cognitive behavior therapy is not the type of therapy I had in my youth, so I wasn’t quite sure what it was, but now I have a clearer picture of it. So that’s good.

CBT is symptom based and generally short term. There’s this thing called the CBT triangle that’s examined in therapy, and the three points are behavior, cognition and emotions and how those things influence and connect to one another. People have little control of their emotions, so the therapist tries to help you focus on thoughts and behaviors that are driving those emotions. Thoughts are either helpful or hurtful, so the therapist attempts to assist you supplant hurtful thoughts with positive ones. There are other methods used to assist you like meditation and visualization. It’s a very practical approach, and the therapist encourages you to set realistic goals. In other words, Satterfield doesn’t promise you a rose garden.

Unlike a quack you might see on the Oprah Show who insists that if you buy his book, your life will be nothing but sunshine and daisies from here on out, Satterfield gives some stone cold facts about human behavior. He’s a scientist, and what he’s offering is science based, so he doesn’t sugarcoat anything. It was a bit of a downer hearing all of that. Addicts are apt to fall off the wagon. Those who have experienced a depressive episode are more likely to experience another, and after two, your changes of having a third increase even more. It keeps going like that until a future episode is almost a sure thing. Those who experience social anxiety are likely to never be the life of the party. And those who want to lose weight might lose a few pounds but then gain it back within a year.

According to Satterfield, nearly 70% of adults in the U.S. are overweight, and about half of those are obese. That statistic is way up sense the ’60s and early ’70s. Something is happening in society at large, so it’s not merely a matter of a lack of will power. And this phenomenon is not confined to the U.S. Satterfield claims it is expected that nearly 60% of the world’s population will be overweight by 2030. Maybe humans simply aren’t designed to deal with an abundance of food. On the bright side, it’s better to have overweight people than starving people.

A few years ago, I discovered William Gedney’s Appalachian poverty photos from the ’60s. They resonated with me because they reminded me of my early childhood. The people in the photos were often very thin. But that’s not because they had better eating habits back then. They couldn’t afford to buy enough food.

Satterfield recommends that you look at things in a more sensible way. Practicality is a big part of CBT. People often make themselves miserable by expecting too much of themselves and others. If you’re overweight, you might not ever look like a fashion model or the personal trainer at the gym. But you can lose a few pounds, increase your fitness level, and prevent yourself from gaining any more weight. If you have serious social anxiety, that might always be with you, but you might be able to make a few friends and establish a strong social network. If you’re prone to depression, you can learn to weather the storms a little better. Perfection isn’t the goal. Doing reasonably better is the thing to aim for.

May you have freedom. May you have peace. May you have grace and courage.