You’re №1 Enemy — Your Internal Script
Learn how your internal script can be your biggest enemy and discover strategies to rewrite it. Explore the impact of cognitive behavioral therapy, exercise, and positive thinking on mental health and well-being.
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Looking at my Samsung Health fitness app, I was blown away by the amount of time I had spent being physically active: 10 hours and 33 minutes. A new record for me. In a life of forced retirement because of post-traumatic stress disorder (PTSD), trust me, this achievement is definitely worth celebrating. Not with cake, which would be counterproductive, but with pride and happiness — free from anxiety’s negative speak.
See, if you let anxiety force a takeover and allow it to force the “yeah buts” into your head and out of your mouth, you will invite an inappropriate dose of sorrow. In other words, your negative self-script, written by anxiety, will ruin your moments of joy. Unfortunately, if you are plagued by an anxious disposition, you need to fight back against it. Easier said than done, I know, but that’s why cognitive behavioral therapy is so effective. It challenges your negative thoughts and helps you establish the truth.
I think it’s fair to say that anxiety hijacks your ability to fantasize about your future in a most damaging way. So, for example, let’s take a look at my exercise record that I completely shattered over the past week. For the last two years anyway, I was going an average of two times a week. For a person with treatment-resistant PTSD, which is anxiety all day long, this is an amazing feat. Now, fast forward to this week — 10 hours is amazing! But because I’ve fought my mental illness naysayer, I am now able to circumvent the “yeah buts” and embrace my successes.
What are the “yeah buts”?
Well, essentially, it’s a term that gets used a lot when someone has anxiety or depression. So, when you meet your goal, let’s say, you’ll initially say something like, “WOW! I’m doing great, no wonder my mental health and energy levels have improved.” Then all of a sudden, the “yeah buts” bust to the surface and try their best to ensure you stay anxious and/or depressed. And they may sound a little something like this: “WOW! I’m doing great, no wonder my mental health and energy levels have improved. Yeah, but I will slide back into a depressive episode, or I will be so triggered at some point by the noise of the gym that I will stop coming.”
Words Matter
Indeed, words matter, not only in the wider world where you interact with others but also in your interior, where your inner voice reigns supreme. When your inner voice is corrupted by angst and/or persistent sadness, it’s as though it wants you to fail — it wants you to remain in a state of perpetual angst and sadness.
The Number One Weapon Against Negative Self-Scripts
There are three main weapons against such hurtful speech: cognitive behavioral therapy, medications like serotonin reuptake inhibitors (SSRIs), and ironically, moderate exercise. While there are others like mindfulness meditation, the three mentioned here are generally the ones that provide the best results for many, at least in the initial stages of recovery.
The Research
The three main weapons against hurtful speech and emotional distress — cognitive behavioral therapy (CBT), serotonin reuptake inhibitors (SSRIs), and moderate exercise — have been extensively studied for their effectiveness in mental health treatment. While other methods like mindfulness meditation exist, these three are often the most beneficial during the initial stages of recovery.
- Cognitive Behavioral Therapy (CBT): Numerous studies have demonstrated the effectiveness of CBT in treating various forms of emotional distress. For instance, CBT has been shown to provide significant improvements in depressive symptoms and emotional well-being in both individual and group settings (Bradbury et al., 2008; Hofmann et al., 2012). A meta-analysis found that CBT is highly effective for anxiety disorders, somatoform disorders, bulimia, anger control problems, and general stress (Hofmann et al., 2012).
- Serotonin Reuptake Inhibitors (SSRIs): SSRIs, such as sertraline, have been widely used and studied for their effectiveness in treating anxiety and depression. Studies indicate that SSRIs significantly improve anxiety, worry, and depressive symptoms in both short-term and long-term treatments (Schuurmans et al., 2006; Dimidjian et al., 2006). For example, a study comparing CBT and sertraline found both to be effective, but sertraline showed superior results on worry symptoms (Schuurmans et al., 2006).
- Moderate Exercise: Exercise has been shown to be an effective intervention for reducing symptoms of depression and anxiety. A review highlighted that vigorous exercise significantly reduces depression scores in children and adolescents (Larun et al., 2006). Additionally, exercise combined with other treatments like CBT and SSRIs can further enhance treatment outcomes (Gary et al., 2010; Gourgouvelis et al., 2018).
These matter because without them we may not have enough self-awareness or education on anxiety, for instance, to see that this is happening. Rather, we go on miserably unaware and therefore remain imprisoned and not even know it.
Pay Attention to The Feeling
In my fitness example, if I were to sabotage my achievement with the “yeah buts” or other negative internal catchphrases, I might not notice the turn in dialogue, but I will, sure as the sun rises, feel the sadness produced by it. Fortunately, we can use this ping of sadness to fight back. Say, “NO! I did something amazing, and I am allowed to be happy for it.” Trust me, when all is said and done, stopping sadness, anger, or anxiousness can be a starting point to healing. Furthermore, when you do notice “the feeling,” you can use it as an indicator to seek the help of a therapist.
You’ve got this — fight back. The rewards are many, like joy, better relationships with others, and a method by which you can embrace your wins in life.
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References:
Note: results were obtained by ChatGPT and personally verified. Please pass along and errors you find, and I will fix them.
1. Bradbury, Cheryl L., et al. “The Efficacy of Cognitive Behavior Therapy in the Treatment of Emotional Distress after Acquired Brain Injury.” *Archives of Physical Medicine and Rehabilitation*, vol. 89, no. 12 Suppl, 2008, pp. S61–8. [https://consensus.app/papers/efficacy-behavior-therapy-treatment-distress-acquired-bradbury/80f968d7e8105af588394739ad18abc7/?utm_source=chatgpt](https://consensus.app/papers/efficacy-behavior-therapy-treatment-distress-acquired-bradbury/80f968d7e8105af588394739ad18abc7/?utm_source=chatgpt ).
2. Hofmann, S., et al. “The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses.” *Cognitive Therapy and Research*, vol. 36, 2012, pp. 427–440. [https://consensus.app/papers/efficacy-cognitive-behavioral-therapy-review-hofmann/4e5ed48ccbd85c53b5b426b874f77b4e/?utm_source=chatgpt](https://consensus.app/papers/efficacy-cognitive-behavioral-therapy-review-hofmann/4e5ed48ccbd85c53b5b426b874f77b4e/?utm_source=chatgpt ).
3. Schuurmans, J., et al. “A Randomized, Controlled Trial of the Effectiveness of Cognitive-Behavioral Therapy and Sertraline versus a Waitlist Control Group for Anxiety Disorders in Older Adults.” *The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry*, vol. 14, no. 3, 2006, pp. 255–63. [https://consensus.app/papers/randomized-trial-effectiveness-therapy-sertraline-schuurmans/75bc8c79972d514c9010088eac7f9875/?utm_source=chatgpt](https://consensus.app/papers/randomized-trial-effectiveness-therapy-sertraline-schuurmans/75bc8c79972d514c9010088eac7f9875/?utm_source=chatgpt ).
4. Dimidjian, Sona, et al. “Randomized Trial of Behavioral Activation, Cognitive Therapy, and Antidepressant Medication in the Acute Treatment of Adults with Major Depression.” *Journal of Consulting and Clinical Psychology*, vol. 74, no. 4, 2006, pp. 658–70. [https://consensus.app/papers/randomized-trial-activation-therapy-medication-acute-dimidjian/68e1891054325c6c90110f289c1c18f6/?utm_source=chatgpt ](https://consensus.app/papers/randomized-trial-activation-therapy-medication-acute-dimidjian/68e1891054325c6c90110f289c1c18f6/?utm_source=chatgpt ).
5. Larun, L., et al. “Exercise in Prevention and Treatment of Anxiety and Depression among Children and Young People.” *The Cochrane Database of Systematic Reviews*, vol. 3, 2006, CD004691. [https://consensus.app/papers/exercise-prevention-treatment-anxiety-depression-among-larun/809f59a66c2b5df0bbc243f73f9e7ac5/?utm_source=chatgpt).
6. Gary, R., et al. “Combined Exercise and Cognitive Behavioral Therapy Improves Outcomes in Patients with Heart Failure.” *Journal of Psychosomatic Research*, vol. 69, no. 2, 2010, pp. 119–31. [https://consensus.app/papers/combined-exercise-therapy-improves-outcomes-patients-gary/71fc8ca2ff9c5dd5a5d6093c60b50b05/?utm_source=chatgpt](https://consensus.app/papers/combined-exercise-therapy-improves-outcomes-patients-gary/71fc8ca2ff9c5dd5a5d6093c60b50b05/?utm_source=chatgpt ).
7. Gourgouvelis, Joanne, et al. “Exercise Leads to Better Clinical Outcomes in Those Receiving Medication Plus Cognitive Behavioral Therapy for Major Depressive Disorder.” *Frontiers in Psychiatry*, vol. 9, 2018. [https://consensus.app/papers/exercise-leads-better-clinical-outcomes-those-receiving-gourgouvelis/ae4cd820b98351d6b0ddbb5520754155/?utm_source=chatgpt](https://consensus.app/papers/exercise-leads-better-clinical-outcomes-those-receiving-gourgouvelis/ae4cd820b98351d6b0ddbb5520754155/?utm_source=chatgpt).
