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Been stumbling across more short-form content on walking lately. Thought I’d share some thoughts. 💭

In cognitive behavior therapy (CBT) language, walking can be construed as a form of activity scheduling-slash-behavioral activation.

CBT argues that thoughts change how we feel—and that behavior can precede motivation.

We can schedule an activity aligned with our values and nudge ourselves into the activity—to check if it will have any effect on how we feel.

This is especially true for those who may feel stuck because of low mood or anxiety—where the heaviness of the feeling has been preventing them from doing anything meaningful at all. Walking, then, is a good place to start: It gets you outdoors, it exposes you to sunlight, it moves your body, it allows your eyes to rest on distant objects, and provides real-life stimulation.

An experiment for the curious: Schedule a walk (activity scheduling), and rate how you feel on a scale of one to 10, before and after the walk. If your mood increases by at least one point, then congratulations: You have successfully done a piece of behavioral activation!

Further reading:

• Fenn K, Byrne M. The key principles of cognitive behavioural therapy. InnovAiT. 2013;6(9):579-585. doi:10.1177/1755738012471029
• Westbrook, D., Kennerley, H., & Kirk, J. (2011). An Introduction to Cognitive Behaviour Therapy: Skills and Applications.

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Disclaimer: The following blog entry is for discussion purposes only and should not be considered a substitute to the tailor-fit opinion of your own doctor or therapist.

Imagine paying P4,000 for an hour-long counseling session when you were only looking for medications. Imagine paying P4,000 for a psychiatric consultation when you were looking for individual psychodynamic therapy rather than a medication-based approach. These are extreme examples but point to the same moral: Patient care should be tailored to the patient, and they must be made aware of their options.

            There’s nothing wrong with pursuing psychiatric or psychotherapeutic treatment if that’s truly in the patient’s best interest, but sometimes patients can be charged unfairly if they approach the wrong professional or if the treatment provided isn’t what’s best for them. On a related note, I still remember the time a dentist suggested I get a root canal even if my tooth could still be saved—if I could turn back time there is no way I would agree with such a permanent and unnecessary treatment.

            Here are some tips to help a patient determine if they are getting a fitting treatment:

1. Do not be afraid to ask questions. For example, if you’re interested in a medication-free treatment, ask, “Doc, I was wondering if it would be possible to refrain from medication first.” Or if you prefer having medication for severe panic attacks, you could ask, “Doc, in case my panic attacks get really intense, would it be okay if we consider using medication?”
2. Don’t be afraid to check if your professional and your goals are aligned. For example, a professional may sometimes think you need to talk about your relationship with your parents, whereas you think that you have focus more on present-day symptoms such as work stress. If your therapeutic goals are not aligned, it will be more difficult—although not necessarily impossible—for therapy to be successful.
3. Always remember your rights as a patient. For example, in counseling, it’s the patient’s right to end therapy at any time for any reason. So if a therapist is forcing you to talk about things you don’t want to talk about, then you are allowed to exit immediately.

Remember that the first two tips are only rules-of-thumb. Patient rights aside, there will always be exceptions to the rule, and every case is unique.

DISCLAIMER: This post is for discussion purposes and should not be considered a substitute for the professional opinion of your doctor or therapist.

A big challenge for many people both in and out of therapy is discerning whether to let people in.

When we let people in, we allow ourselves to be vulnerable–where we can be supported and loved or criticized and judged.

In psychotherapy/counseling, letting your therapist in is important: Your therapist cannot help you or listen to the “real” you if you do not feel comfortable letting them in. Granted, it may take several sessions before you feel comfortable opening up, and sometimes therapists suggest opening up as a constructive challenge. That said, there is a fine line between a therapeutic challenge and being forced to open up against your will.

As a friendly forewarning to all those who are considering psychotherapy and counseling: Remember that just because you are talking to a therapist does not mean you should feel forced to let people in against your will. Make sure you know your rights as a client, and remember it’s your choice whether to let people in or walk away.