People often put restrictions on their ability to satisfy a craving — for example, by using filters or Internet blocking software — and then, when a craving gets triggered, they impulsively go to work skirting their own restrictions in order to satisfy the craving. Afterwards they feel regret and guilt. 

Do you know anyone like this?

     
 
I do too — it's the typical scenario I see in my clinical practice when people come to me for help. 

We're never really aware of automation while it's taking place; it's only afterwards that we ask ourselves, "Why did I do that?" Only then can we see that it was impulsive, mindless, and automated. All vices are like that.

 
Well, you may not know people like this, but I know plenty — it's the typical scenario I see in my clinical practice when people come to me for help. 

We're never really aware of automation while it's taking place; it's only afterwards that we ask ourselves, "Why did I do that?" Only then can we see that it was impulsive, mindless, and automated. All vices are like that.

 
To break automation you are going to need two skills. First, you will need to be aware of your attitude toward the challenge of overcoming the craving; this is the work of reframing, which is the cornerstone of cognitive therapy

Second, you will need to be able to pay full attention to the craving. This is crucial, because you cannot simultaneously feel a craving and act on it; it is also the cornerstone of modern behavioral therapy. This is such a major topic that we will have to wait until the next module to review it.

 
Reframing, or "cognitive restructuring," refers to an intentional choice to change how you are viewing a situation or trigger, shifting it from "bad" to "good," from "threat" to "opportunity." It is a strategy that has been proven to work in multitudes of research studies. In recent years we have begun to appreciate the powerful effect it has on reducing limbic activation: it makes cravings (or any emotion) less likely to get triggered, and it makes you more able to keep control over your behavior should a craving (or any emotion) get triggered. 

Reframing is an essential skill for overcoming impulsive and automated behaviors.

Cutuli, D. (2014). Cognitive reappraisal and expressive suppression strategies role in the emotion regulation: an overview on their modulatory effects and neural correlates. Frontiers in Systems Neuroscience, 8, 175. http://doi.org/10.3389/fnsys.2014.00175
Ochsner, K. N., Ray, R. D., Cooper, J. C., Robertson, E. R., Chopra, S., Gabrieli, J. D., & Gross, J. J. (2004). For better or for worse: Neural systems supporting the cognitive down-and up-regulation of negative emotion. Neuroimage, 23(2), 483-499.
 
In order to understand the significance of reframing, you'll need some basic neuroscience. Let's begin with the upper (medial prefrontal) cortex. This cortex is activated when you are doing deliberate things: thinking about abstract concepts, moral reasoning and decision making, considering ideals, and so on. All of these activities are calm, rational, and deliberate. 

We can call the state of upper-cortical activation your brain's "opportunity mode." It means you are judging things as opportunities, and all your rational abilities are strengthened. The appraisal cortex is at the center of this activation, turning "on" (activating) when you consider something as an opportunity, and turning "off" (deactivating) when you judge it to be a threat.

 
The opposite of "opportunity mode" is "threat mode." It turns on whenever your amygdala detects something that threatens pain or promises pleasure (the threat in this case being missing out on the pleasure). The amygdala generates the emotion, and its activation fosters an automated, emotional, impulsive way of acting.

 
When one part of your cortex (upper or lower) activates, it reaches across and turns DOWN the opposite cortex. If your amygdala detects a big threat, it will activate powerfully as it turns on threat mode; this deactivates your upper cortex, making it hard to think rationally (presumably so we do not overthink things and get harmed!).

On the other hand, when you deliberately judge something as an opportunity, this turns "on" your appraisal cortex, which then dampens the activity of the amygdala. This is the work of reframing. Reframing reasserts the power of your upper cortex, regardless of the emotion that got triggered. Reframing while an emotion is surging allows you to patiently ride the wave of the emotion without giving in.

 
Imagine you decided not to drive to the grocery store, but instead walked several blocks and took public transportation. While at the store, however, you realize you need to buy several items that are quite heavy. You begin to dread the trip home. As you purchase the items and leave the store, you keep noticing how heavy the bags are, and you begin to complain to yourself. 

When you are judging something as being a good opportunity, your appraisal center turns on; when you judge it as being bad or a threat, it turns off. In this example, what is the state of your appraisal cortex?


 
You're right. The key here is to see that dreading and complaining are negative appraisals. Negative appraisals — judging things as bad — turns off your appraisal cortex, which turns on your emotional (limbic) cortex. That causes you to be more irritated by whatever bothers you and fuels more negative appraisals. You will need to develop an awareness of when you are getting into this negative state.

 
Not quite. The key here is to see that dreading and complaining are negative appraisals. Negative appraisals — judging things as bad — turns off your appraisal cortex, which turns on your emotional (limbic) cortex. That causes you to be more irritated by whatever bothers you and fuels more negative appraisals. You will need to develop an awareness of when you are getting into this negative state.

 
Next, think of a salesman with a fear of elevators. His next call requires him to go to the 50th floor of an office tower, and for a whole week in advance he dreads the elevator ride. He is afraid that he will start panicking once the doors close. Finally, when he arrives at the tower, he approaches the open elevator and finds it uncomfortably full already. His anxiety skyrockets. 

What is the state of his appraisal cortex when thinking of or experiencing elevators?


 
Exactly. Dreading works by turning off your appraisal cortex in anticipation of events, and ensures that it will be off when the event happens. 

Once your appraisal cortex is off, your amygdala, ever attuned to bad situations, immediately goes into "alert mode." For those who have panic disorder (which is totally treatable with behavioral therapy), this means that they are setting themselves up to have a panic attack in the very situation that they are dreading having a panic attack. It becomes a self-fulfilling prophecy.

 
You may have read this wrong. Dreading works by turning off your appraisal cortex in anticipation of events, and ensures that it will be off when the event happens. 

Once your appraisal cortex is off, your amygdala, ever attuned to bad situations, immediately goes into "alert mode." For those who have panic disorder (which is totally treatable with behavioral therapy), this means that they are setting themselves up to have a panic attack in the very situation that they are dreading having a panic attack. It becomes a self-fulfilling prophecy.

 
Cravings work in an identical way. If you are dreading having a temptation in a certain situation, your dread ensures that you will 1) get triggered quickly while in that situation, and 2) experience much stronger cravings and tunnel vision than you would have otherwise. Dreading "charges" situations in advance, and leads to a self-fulfilling prophecy: when you see a situation coming that will tempt you to violate your ideals, your anticipatory dread makes cravings more likely and more powerful.

When you have an addiction or another emotional problem the problem is almost never how your brain is working. The problem is instead how you have trained your brain to work. By dreading situations that present challenging emotions, you make it more likely that tunnel vision will lead you to give in to the emotion's urging, reinforcing the training and making the whole sequence more likely to recur.

 
You can escape that vicious cycle by using reframing. To reframe you first need to notice that you are dreading or complaining. Then, you need to make a conscious effort to reconsider the situation. You can use a powerful word to start reframing: practice. Simply saying the word turns on the appraisal cortex, immediately shifting how the whole situation feels. Another great word is opportunity. Let's review the prior examples to see how you can use these words to transform a situation.

 
If you have to carry a load of heavy groceries a long distance, you could turn off your appraisal cortex by dreading and complaining. 

On the other hand, you could see this as an opportunity to get a good, natural upper-body workout. Or as a good chance to practice noticing when your mind starts generating complaints, and then practice reframing. Yes, you can reframe just by thinking of reframing!

You'll know you have gotten into a positive appraisal when you see a trial as good practice, or — even better — when you meet a challenge by saying, "Bring it on!" (But before you apply this to purity, read a bit further...)

 
If you were the salesperson facing the elevator challenge, you could see it as a great opportunity for "safety learning," also called habituation. You could honestly say, "Bring it on!", welcoming your anxiety to go as high as it might. The more you are willing for your anxiety to go higher, the more manageable anxiety becomes. Stay tuned for the Anxiety module, which will explain this in much greater detail. 

When people approach situations they fear with ready willingness, open to fully welcome the discomfort of the fear, they often experience an "Aha!" moment: things are so much easier when they turn dreading into welcoming, and complaining into practicing mindful attention. Tunnel vision never turns on, and your brain is fully ready to process (i.e., "digest") the anxiety — or craving. I'll show you how to do this in the Mindfulness module.

 
There are two types of situations to practice reframing: first, in any situation where you are falling into complaining and dreading; and second, in situations that involve challenges to purity.

To practice the first kind of reframing, you first need to practice noticing when you are complaining (or dreading, or regretting). A good way to do this is to make a resolution, 100% binding, to never complain.

 
By complaining, you turn off your appraisal cortex and effectively lock yourself in a lower limbic "threat mode." You make yourself unable, temporarily, to be mindful or to focus deeply in your work, since both these functions belong to the "opportunity mode" which turns on with positive appraisals. 

Complaining turns off not only your appraisal cortex, but also the cortices of everyone who hears you. It may be one of the mechanisms for the social contagion of depression; it likely decreases the functioning of your immune system; and it certainly makes it harder to work effectively as a group (see Work module for more details).

 
Practice listening to yourself in conversations: does your tone tend to be positive, or do you dwell on the negative? Try setting first a goal of not complaining for a morning or an afternoon, then try extending it to an entire day. Try to see moments where you catch yourself complaining as good practice in reframing and becoming mindful.

You can also practice noticing when you are complaining or dreading interiorly, and then use that occasion to reframe the challenge as an opportunity. It is not a matter of telling yourself it is an opportunity; you have to mentally discover the opportunity in the challenge. If you can decrease the time you spend in undetected complaining to seconds rather than minutes or hours, you will end up with a robust habit of reframing.

 
One good way for you to notice when your thinking turns negative is to cultivate a cheerful demeanor. Maintaining a sense of cheerfulness, good humor, a readiness to smile, is incompatible with complaining in all its forms. If you happen to fall into complaining, you will lose your cheerfulness — which can then alert you that it is time to practice reframing the complaint into an opportunity for practice.

Loss of cheerfulness sets the stage for having bigger emotional trials, since a habit of negative appraisals keeps one in a highly triggerable state. On the other hand, a habitually cheerful demeanor goes along with positive appraisals and greater powers of self-control.

 
Now, let's apply this now more directly to purity. 

Instead of dreading temptations against purity, do you think that it would be a good idea to go headlong into them saying, "Bring it on!" and looking forward to enjoying the temptation?


 
I'm glad we were able to clarify this point. It's the trickiest aspect of the behavioral approach. 

Later we'll get into the full details of how we need to handle threats (a general term for all things that have a negative appraisal) in a different way than we handle opportunities (a general term for all things with positive appraisals). For now, suffice it to say that the occasions of cravings should not be positively sought, but, when cravings do get triggered, the discomfort of the craving has to be fully welcomed.

 
You were right to pause here — this is one of the trickiest aspects of behavioral therapy. 

Later we'll get into the full details of how we need to handle threats (a general term for all things that have a negative appraisal) in a different way than we handle opportunities (a general term for all things with positive appraisals). For now, suffice it to say that the occasions of cravings should not be positively sought, but, when cravings do get triggered, the discomfort of the craving has to be fully welcomed.

 
You're absolutely correct. 

Later we'll get into the full details of how we need to handle threats (a general term for all things that have a negative appraisal) in a different way than we handle opportunities (a general term for all things with positive appraisals). For now, suffice it to say that the occasions of cravings should not be positively sought, but, when cravings do get triggered, the discomfort of the craving has to be fully welcomed.

 
Reframing is a powerful way of growing in the virtue of purity. In my clinical practice, I have seen people who spent years struggling to grow in purity without success make sudden progress as soon as they begin to practice it. 

Oftentimes, the advice has simply been: "Instead of dreading the next temptation, or wave of temptations, try to look forward to them as opportunities for exactly the practice you need. This practice is all you need to make progress. The key is to welcome the discomfort of the unsatisfied craving — which means seeing it for what it really is: proof of progress. You only feel that discomfort when you're acting on your ideals, and as long as you are welcoming it, you won't act on it." 

What does welcoming the coming discomfort of an unsatisfied craving do to your appraisal cortex and your emotional cortex?


 
That's right. Welcoming a challenge means treating it like an opportunity, which is precisely what activates your appraisal cortex. When you're in this "opportunity mode," your fast-reacting emotional cortex goes quiet, since it's mostly designed to handle threats (in "threat mode"). So the appraisal cortex and your emotional cortex are oppositely related: when one turns up, the other turns down.

 
Not exactly. Welcoming a challenge means treating it like an opportunity, which is precisely what activates your appraisal cortex. When you're in this "opportunity mode," your fast-reacting emotional cortex goes quiet, since it's mostly designed to handle threats (in "threat mode"). So the appraisal cortex and your emotional cortex are oppositely related: when one turns up, the other turns down.

 
Welcoming a coming trial as an opportunity for growth means that, as you approach it, your higher, deliberate cortex stays on: the tunnel vision doesn't form, your ability to make moral decisions stays fully intact, and so does your vision of your ideals. You will find that impulses and distractions have less power over your actions, and, as a result, you will find your cravings easier and easier to manage. 

I've learned to never underestimate the power of expectations and appraisals: my experience treating anxiety disorders and addictions has shown me that people get stuck because they are dreading opportunities for growth rather than welcoming them.

 
As a final exercise, it would be great for you to write out a description of the two or three situations where you are most likely to give in to cravings. Specify as much as you can the factors that would make it especially compelling. For instance, instead of just saying "in my room", write, "in my dorm room, when my roommate is out of town and I'm by myself." Try to mention a few circumstances like this, since these are the ones where self-fulfilling dread cycles are most likely to be at work. 


 
Those situations you just recorded are going to give you exactly the practice you need in breaking any impulsive behaviors you may have. Can you imagine yourself having a positive appraisal of the training each one will give? How different do you think the experience will be?

Once you have activated your appraisal cortex by reframing, you're ready for the next step: further activating your upper cortex through the practice of mindfulness. The next module will show you how.

 
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