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Breaking an Anxiety, Depression, Perfectionism, Connection

A sure-fire antidote for stopping cerebral fictions

Depression is complex and multifaceted. Charlottesville VA psychotherapist Dr. Russ Grieger shows how to identify and debunk necessitating thinking when it is at the heart of anxiety and depression.

If you suffer from a mixed anxiety and depression, then, the chances are that you have crossed the line from preferring to do well and have a happy life, to thinking that you absolutely must do well to have a happy life. In crossing that line from preferential to perfectionist necessitating thinking, you step over a threshold and into a world of needless misery. When Paul, Mary, and David engaged in this conditional thinking, they slumped in misery. Let’s see what we can learn from their situations. Then I’ll share Dr. Albert Ellis’ approaches for identifying the perniciousness in this thinking. Next, I’ll give you a seven-step sure-fire antidote for correcting this conditional form of anxiety and depression thinking.

Paul continually worried that his wife would leave him. Probing into his thought process, Paul thought that more than hoping and wishing that his wife would love him forever, he believed that he needed her to love him forever, and that he couldn't survive without her. Drowning in thoughts of possible loss, Paul’s mood fluctuated between anxiety and depression.

Mary led a lonely lifestyle. Two years earlier, her long-term lover threw her over for another. She blamed herself, overgeneralized, and feared that everyone would reject her. She withdrew. Mary rationally believed, "I don’t like being rejected.” If she stuck with that view, she’d be fine. Her second belief was irrational and toxic: “Because I don’t ever want to be rejected, I absolutely must never let it happen again.” By avoiding rejection at all costs, she led a life of depressing isolation.

When his business failed, David experienced a severe reactive depression. He reported that he needed (not simply wanted) to succeed at everything he did. As an example, he drove himself to succeed in school, sports, and with women. When he started a business, he at first succeeded. A floundering economy undid David’s dreams of business greatness. He kept telling himself, “I should have not failed.” He concluded: “It’s horrible that I have.” When David relinquished the notion that he absolutely must always achieve marvelously, or it’s horrible, he felt considerably more relaxed. Paradoxically, he achieved at higher levels.

Recognizing Necessitating Thinking

If you demand that your life should go well, you risk feeling anxious and depressed. Hassles in life are inescapable. It's how you handle yourself, that makes the difference. Unfortunately, many anxious people with depression don’t think about their necessitating thinking. Thus, they go through life feeling like water-soaked logs.

Can faulty expectations ignite or amplify a combination of anxious and depressed feelings? Examine the following edited segment of a psychotherapy session held between Dr. Ellis and George, and see if you agree that by changing your thinking you can substitute reason for misery.

George is clueless about how his expectations influence how he feels. He thinks he is a victim of circumstances. If the world changes for him, he’ll feel all right. Dr. Ellis quickly and collaboratively helps George see how this necessitating thinking can trigger negative emotions.

Dr. Ellis: How would you feel if you held the following belief, “I want to always have $5 in my pocket,” and then you only find $4?

George: Maybe disappointed.

Dr. Ellis: Right. Now, change the belief to, “I absolutely must have $5 in my pocket at all times.” Now, only finding $4, how would you feel?

George: Really upset.

Dr. Ellis: Yes, You’d be upset because you lost exactly what you think you absolutely must have. But, now, what if you reached into your pocket and found six? How would you feel then?

George: Well, happy, of course.

Dr. Ellis: What could pop into your mind about this money if you’re not careful?

George: What?

Dr. Ellis: What if I lose the money? What if I’ve miscounted? What if I have to spend $2 and only go back to $4? What if I lose a couple of dollars?

George: Yeah, I’d worry what could happen endlessly.

Dr. Ellis: Exactly. So, whenever you take anything you want and turn it into a necessity, you can’t win. If you don’t get what you think you must have, you think you’re destroyed. But, even if you do get what you want, you’re still anxious because there’s no guarantee that you’ll always have it.

George: Yeah. I got it.

Dr. Ellis: So, we’ve got to get the idea of must or need out of your head or you’ll always struggle with depression and anxiety.

The Seven-Step Sure-fire Antidote

REBT offers a powerful antidote to necessitating thinking that can trigger and amplify a mixed anxiety and depression. This practical REBT approach is geared toward changing the irrational thought patterns that lead to this twin misery.

Step 1: Be alert to those moments when you feel anxious or depressed.

Step 2: Track down your necessitating thinking. The clues include words like should, must, got to, have to, and need to.

Step 3: Label these “enemy” thoughts necessitating thinking. This act of labeling puts them into a correctable category.

Step 4: Question the validity of necessitating thinking. For example, must you succeed, be loved by whomever, or have the pleasure of whatever? Accept that you don’t become worthless by failing, not being loved, or by feeling deprived.

Step 5: Go over this enlightened perspective at least four times a day (say at breakfast, lunch, supper, and bedtime). Paul might practice: “I love my wife and want her to love me, but I don’t need her to.” Mary might rehearse: “I sure hope I don’t get rejected the next time I get involved with a guy, but if it doesn’t work out, I’m not a worthless failure.” David might go over: “I want to succeed but don’t have to do so perfectly well.”

Step 6: Practice this rational perspective until it is habitual. Accept that no self-defeating way of thinking goes away overnight. A rational way of thinking develops through repeated practice. This takes work.

Step 7: Put in the work. I’m confident that you will have less anxiety and depression and more peace of mind. Then, enjoy your newfound contentment and happiness.

This blog is part of the Pioneer of the Mind series to celebrate the contributions of Albert Ellis, the founder of rational emotive behavioral therapy and the grandfather of cognitive-behavior therapy.

Albert Ellis Revisited (Carlson & Knaus 2013) is the Albert Ellis Tribute Book Series centennial book. The publisher, Routledge, offers a 20% discount on the book. Control click on this link: Albert Ellis Revisited. Type the code Ellis for the discount. The book qualifies for free shipping and handling. Bill Knaus’ royalties from this book go directly to the Denan Project charity. When you buy the book, you are helping yourself by learning ways to live life fully, and you are helping bring irrigation, crops, and health care to destitute areas of the world.

For more information on rational emotive behavior therapy, click on Albert Ellis’ official website: Albert Ellis Network:

Special to this series, A Water Soaked Log PhotoArt thumbnail image by Dale Jarvis, AreaOne Art & Design, Fayetteville NC.

© Russell Grieger, Ph.D. Co-author with Albert Ellis of Handbook of Rational-Emotive Therapy Vol 1 & 2. Co-author, Fearless Job Hunting.