Damon Ashworth Psychology

Tag: CBT

  • Debunking Common Misconceptions About Sleep

    Debunking Common Misconceptions About Sleep

    Struggling with sleep? You’re not alone. But what if some of your thoughts about sleep were actually making things worse? The DBAS-16 (Dysfunctional Beliefs and Attitudes about Sleep) questionnaire identifies common, yet misguided, assumptions that can fuel hyper-arousal and insomnia.

    I’ll use my expertise in sleep and psychology to help challenge these beliefs. Let’s see if we can replace these unhelpful sleep beliefs with a healthier, science-backed mindset.

    1. “I need 8 hours of sleep to feel refreshed and function well during the day.”

    Challenge: While 7-9 hours of sleep per night is the general recommendation for adults, individual needs vary. A longitudinal study followed people’s sleep and health for several years. It found that people who slept 7 hours per night were healthier on average than those who slept 8-9 hours. Some people do need less sleep than the average, while others need more.

    Focusing too much on getting a fixed amount of sleep each night can create stress. This stress then makes achieving that sleep harder. It’s better to understand your individual sleep needs over time. Then aim to be in bed for not much more than that each night. By improving your sleep quality, regularity, and timing, you can also feel better the next day. You can achieve this even if you aren’t sleeping longer each night.

    2. “When I don’t get the proper amount of sleep on a given night, I need to catch up the next day by napping or the next night by sleeping longer.”

    Challenge: While occasional naps can be refreshing, try not to focus on getting extra sleep during the day. Long naps will reduce your sleep pressure for the next night. If you really have to nap, have one before 4 pm and for less than 30 minutes. This way, it won’t disrupt your sleep as much for the next night.

    Fixating on sleep during the day can keep insomnia going. This habit can also disrupt your natural sleep cycle. Try to engage in fulfilling activities instead. Consistently maintaining a sleep schedule is better than constantly trying to compensate for lost sleep. Your brain and body will then help you to feel more alert during the day and more sleepy at nighttime.

    3. “I am concerned that chronic insomnia may have serious consequences on my
    physical health.    “

    Challenge: While long-term sleep issues can have health effects, excessive worry about them can make sleep problems worse. Insufficient sleep can increase the risk of accidents and reduce productivity during the day. However, performance on tasks in people with insomnia is often better than we expect.

    Small improvements in sleep habits can mitigate risks and help restore healthier sleep patterns over time. Worrying less about the negative impacts of not sleeping can reduce arousal levels and lead to better sleep too.

    4. “I am worried that I may lose control over my abilities to sleep.”

    Challenge: Sleep is not something you control – it’s something you allow. As an involuntary process, the more you try to force sleep, the more elusive it can become.

    Instead, focus on doing things to wind down and relax at the end of the day. Focus on consistency and going to bed at similar times each night and waking up at similar times each morning. Try to only be in bed if you are sleepy and for not much longer than you need for sleep. If you do this at times that are ideal for your inner body clock, even better. Accept that you may have an occasional bad night of sleep. By following this approach, it is likely to lead to better and not worse sleep over time.

    5. “After a poor night’s sleep, I know it will interfere with my activities the next day.“

    Challenge: Feeling tired is natural. However, studies show that people with insomnia often perform better than they expect, even after a poor sleep.

    Worrying about fatigue can make it worse. Trust yourself to manage getting through the day. You can hopefully do what you need to do the next day. This is true even after imperfect sleep, and even if you feel tired or fatigued.

    6. “To be alert and function well during the day, I believe I would be better off taking a sleeping pill rather than having a poor night’s sleep.“

    Challenge: Sleeping pills can provide you short-term relief. Especially if you are going through a really hard time that is likely to last for less than two weeks.

    However, sleeping pills do not address the root causes of chronic insomnia. Additionally, they can lead to dependence over time. Therefore, they are not recommended to be taken regularly for more than 2-4 weeks.

    Behavioral strategies, such as Cognitive Behavioral Therapy for Insomnia (CBT-I), are more effective than sleeping pills. They don’t result in rebound insomnia once the treatment finishes, and they improve sleep in the long term. Prioritizing good sleep habits over medication can lead to more sustainable, restorative sleep.

    7. “When I feel irritable, depressed, or anxious during the day, it is mostly because I did not sleep well the night before.“

    Challenge: While poor sleep can affect mood, emotions are influenced by multiple factors, including stress, lifestyle, and thought patterns. Blaming all negative emotions on sleep can lead to much more anxiety about sleep.

    Instead, if you aren’t feeling great, try engaging in mood-boosting activities. Spend time with people that you like. Exercise and get out into nature. Do something creative or fun. Seek excitement, awe, or joy. Write down things that you feel grateful for. Learn stress management and mindfulness skills. All of these strategies can help improve emotional well-being, even after a rough night of sleep.

    8. “When I sleep poorly one night, I know it will disturb my sleep schedule for the
    whole week.    “

    Challenge: One bad night does not define your entire sleep pattern. If you sleep poorly on one night, your sleep pressure will be a lot higher for the next night. Your brain will then try to make it easier for you to sleep deeply and well. This is to help compensate for the poor night of sleep the night before. If you can keep your stress and worry in check, you are likely to sleep better after a poor night.

    9. “Without an adequate night’s sleep, I can hardly function the next day.“

    Challenge: While sleep is important, the body is resilient. Many people still function well after a poor night of sleep. Things will feel like they require more effort, and you probably won’t feel as motivated to do things. You might even crave more junk food. However, performance studies show that people with insomnia’s functioning is better than they think it will be.

    Energy levels fluctuate naturally throughout the day, and movement, hydration, and good nutrition can help maintain alertness. Try to focus on what you can do during the day to help you to function well. Even when you feel unmotivated.

    10. “I can’t ever predict whether I’ll have a good or poor night’s sleep.“

    Challenge: Some variation in sleep is normal. But this doesn’t mean that sleep is completely unpredictable.

    You can improve the predictability of your sleep by maintaining a consistent bedtime routine. Sleep at the right times for you. Wind down and relax before bedtime, and wait until you feel sleepy before going to bed.

    11. “I have little ability to manage the negative consequences of disturbed sleep.“

    Challenge: You have more resilience than you think. Focus on what feels achievable during the day after a poor night of sleep. If your capacity feels like a 5/10, get through as many of the easier tasks on your to-do-list as possible.

    By doing what you can, looking after yourself and managing your stress well, it is possible to navigate occasional poor sleep. It also increases your chances of getting things back on track with your sleep going forward.

    12. “When I feel tired, have no energy, or just seem not to function well during the
    day, it is generally because I did not sleep well the night before.    “

    Challenge: Our daytime performance and energy levels naturally fluctuate during the day. For most people, it is very common to have a post-lunch dip. Some countries even take siestas during this time rather than trying to push through or ignore how they are feeling. Try not to attribute everything to how you slept the night before.

    Instead, focus on what you can do in the moment. Take a break. Get some fresh air. Have a drink of water or a healthy snack. Engage in an enjoyable or creative activity. Try to shift the focus away from your sleep and see if it reduces insomnia’s control on your life.

    13. “I believe insomnia is essentially the result of a chemical imbalance.“

    Challenge: Brain chemistry plays a role in sleep. However, insomnia is often driven by behavioral, cognitive, and emotional factors. It is not merely caused by a simple chemical imbalance. By saying it is an imbalance, you imply it is out of your control. You indicate there is nothing you can do.

    The science does not support this. CBT-I and other non-medication approaches can be highly effective in addressing the underlying causes of insomnia and improving your sleep. Focus on what you can do.

    14. “I feel insomnia is ruining my ability to enjoy life and prevents me from doing
    what I want.    “

    Challenge: Insomnia can be frustrating, but it doesn’t have to define your life. Many people with sleep issues still find joy in their days. Shifting focus away from sleep struggles can improve overall well-being and even sleep itself.

    15. “Medication is probably the only solution to sleeplessness.“

    Challenge: While medication can help in certain cases, non-medication approaches—especially CBT-I — are often more effective for long-term sleep improvement. Stimulus control, sleep restriction, progressive muscle relaxation and paradoxical intention can also make a significant difference. They are all empirically supported interventions for insomnia.

    16. “I avoid or cancel obligations (social, family) after a poor night’s sleep.“

    Challenge: Avoiding activities due to poor sleep can reinforce sleep-related fears. If you say that you can’t function without perfect sleep, it will fuel your anxiety. By engaging in your normal activities, even when you are tired, it can help you to re-frame your sleep-related fears.

    So the next time you don’t sleep well, try not to cancel your plans the next day. Go out and do it anyway, and see how it goes. Then afterwards, ask yourself: 1. how did it go? 2. was it as bad as I thought it would be? and 3. what does this mean for a similar situation next time?

    Final Thoughts

    Many of our beliefs about sleep are shaped by misinformation, anxiety, and unrealistic expectations. By challenging these unhelpful attitudes, you can reduce stress around sleep and improve your overall sleep quality.

    If you struggle with persistent sleep issues, consider seeking out a psychologist for CBT-I. It is considered the gold standard or first line treatment for breaking the cycle of insomnia.

    What do you think?

    Do you strongly agree with any of these common unhelpful beliefs about sleep? Let me know in the comments!

  • Why Bother Overcoming Fears?

    Why Bother Overcoming Fears?

     Last weekend I managed to complete my PADI Open Water SCUBA Diver Course:

    PADI Temporary Card — Open Water Diver

    Name: Damon Ashworth
    Instructor Number: 305944

    This person has satisfactorily met the standards for this certification level as set forth by PADI.

    It was a pretty big challenge for me since I don’t really like being on boats and find it scary just swimming out in the middle of the ocean. But, I did it because a close friend asked me if I would be her dive buddy for the course, and I thought there would be no better opportunity than when I am already living in Vanuatu, home to some of the best dive sites in the world.

    To get your Open Water Card, you need to pass many theory tests about diving, and you need to complete 24 skills in a pool and then replicate these skills out in the open water across four dives. We saw a shipwreck, some amazing coral and sea life, and even a few small reef sharks during the open water dives.

    The scariest part to me was when I was up to 18 metres underwater, knowing that I’d need to stop for 3 minutes at 5 metres on the way up and ascend slowly to avoid decompression sickness. It meant that if I felt a bit anxious or panicky for whatever reason, I couldn’t just get out to the surface straight away and start gasping for air. Instead, I had to remain calm, breathe slowly and steadily using my regulator, put some confidence in my divemaster who was guiding us through the training and focus on whatever was in my control instead of worrying about things that were out of it.

    Fortunately, I successfully completed the dives and all the skills. Some moments were pretty cool, especially seeing the wreck and the sea life on the coral reef. In general, though, I didn’t love it and was utterly exhausted and a little bit relieved once I did it.

    So how do I know if it was worth it? Should I have bothered challenging myself to do something where I worried I could have died if something went badly wrong?

    When Is It Worth Facing Your Fears?

    The answer is it depends. It depends on:

    1. What scares you?
    2. How afraid you are (on a scale from 0 = no anxiety at all to 10 = completely overwhelmed and having a panic attack)?
    3. How safe or dangerous is the thing that you fear? and
    4. Will it impact your quality of life if you do not face up to your fear or try to overcome it?

    Suppose what you fear has a low risk of actually occurring. The activity is relatively safe even though it feels scary, and not doing it has a significant negative impact on your life. In that case, it is worth trying to challenge yourself and overcome your fears.

    For me:

    1. I think the fear of SCUBA diving was dying.
    2. The thought of actually going SCUBA diving increased my anxiety to a 7/10, which is high but not quite at the panic stage.
    3. The 2010 Diver’s Alert Network Workshop Report found that only one-in-211,864 dives end in a fatality. SCUBA diving is riskier than flying in an aeroplane or riding a bike but much less dangerous than driving a car, skydiving, or running a marathon. We’re even more likely to die from walking or falling on stairs than we are from SCUBA diving.

    4. If I never went SCUBA diving, I doubt that it would have reduced my quality of life in any way. I did it mainly because I wanted to spend time with my friend, and I wanted to challenge myself to face my fears, as not being able to overcome any fears would have a substantial negative impact on my quality of life.

    I am glad to get my PADI Open Water Certificate based on the above information. I’m not too sure if I will ever go again, though. I could enjoy it more and become less anxious about diving over time, and that did happen even across my four open water dives. If I went again, my anxiety might be a five or a six. In reality, though, I think I can enjoy snorkelling just as much without it lowering my quality of life in any way, and I’ll probably do that more than SCUBA diving in the future.

    What Are the Most Common Fears?

    The top ten most common specific phobias are:

    1. Arachnophobia — fear of spiders
    2. Ophidiophobia — fear of snakes
    3. Acrophobia — fear of heights
    4. Agoraphobia — fear of crowds or open spaces
    5. Cynophobia — fear of dogs
    6. Astraphobia — fear of thunder and lightning
    7. Claustrophobia — fear of small spaces
    8. Mysophobia — fear of germs
    9. Aerophobia — fear of flying
    10. Trypanophobia — fear of injections

    Looking at the above common phobias, they all have some basis for why we may become afraid of them. Some spiders and snakes can kill, as can dogs (especially if they have rabies). Planes can crash, and falling from high up can be fatal. People can become trapped and suffocate in a small space or crowds, and lightning strikes have killed people. Germs and bacteria spread disease too. Medical mishaps are the third most significant cause of death in the US, according to the latest figures from the US Center for Disease Control and Prevention. Unfortunately, our brain is not very good at distinguishing dangerous things versus things that feel dangerous but are pretty safe.

    How Do We Overcome Fears?

    We overcome any fear through the dual process of gradual exposure and cognitive reappraisal after the exposure:

    1. We determine what fear it is we would like to master. Preferably, this is something that you are currently avoiding that is negatively impacting your life, such as not going to the doctor or dentist because you are afraid of needles.

    2. We develop an exposure hierarchy on this fear. It should have at least five tasks that you want to do ranked from least scary to most scary (scale from 0–10). For Arachnophobia, it may be a 2/10 for looking at pictures of spiders to a 4/10 for watching videos of spiders. Then a 6/10 for looking at spiders in an enclosure to a 10/10 for letting a spider crawl up your arm.

    3. We start with the least scary task first and stay in the situation for at least 10 minutes if possible. It should be long enough for the anxiety to peak and then reduce substantially during the exposure exercise. A psychologist can teach specific behavioural and thinking skills to help lower stress levels during exposure.

    4. We reflect on the exposure experience afterwards and try to change our previously held beliefs about what we fear. It is called cognitive reappraisal and is done by asking ourselves, “how did it go?” “was it as bad as I thought it would be?” and “how would I approach a similar situation in the future?”

    5. Once we are comfortable with that level of the exposure hierarchy, we repeat steps three and four with the next task on the exposure hierarchy. Then, once we become comfortable with the next step, we take each step until we are successful with all tasks on the hierarchy. By the end, you have overcome or mastered the fear.

    What if What I Fear is Dangerous?

    If you have Ophidiophobia and live in Australia, you’re probably not going to want to befriend a snake that you run into out in the bush. Australia is home to 21 out of the 25 most deadly snakes globally. If you want to overcome this fear, you might want to learn instead how to distinguish between poisonous and non-poisonous snakes and get more comfortable only with deadly ones from behind solid glass panels at your local zoo. Or you could visit someone who owned a harmless pet snake so that you could get used to being around it and touching it and realising that you are safe.

    If you’re afraid of heights, I wouldn’t suggest being like Alex Honnold and trying to free climb El Capitan in Yosemite. However, testing ‘The Edge’ experience at the Eureka tower in Melbourne or even riding ‘The Giant Drop’ on the Gold Coast might be a pretty safe way to challenge your fears.

    Facts can really help some people challenge their beliefs about their fears, but nothing beats putting ourselves in a feared situation first and then challenging our beliefs afterwards.

    For me, knowing that only 12 out of the 35,000 different varieties of spiders are harmful to humans makes me not worry every time I see a little one unless it is a whitetail or a redback spider.

    It helps to know that flying is one of the safest forms of travel, with a one-in-12 million chance of crashing. Likewise, although I don’t try to stand in an open field with a metal pole during a storm, it does help to know that being killed by lightning is nearly as rare, with a one-in-10.5 million chance.

    Even though I’m not particularly eager to watch it pierce my skin, needles don’t hurt nearly as much as I used to imagine, and the pain goes away almost immediately after the injection. Bacteria is everywhere, so I couldn’t avoid germs entirely even if I tried.

    If I ever feel a bit trapped or panicky the next time I dive, it will help to remind myself that I have done it before. I have my open water certificate and the skills from this, and what I’m doing is pretty safe as long as I don’t panic and follow my training.

    Just because we are afraid of something, it doesn’t mean we have to avoid it for the rest of our lives. But we don’t have to face our fears every time either, especially if it is not harming our quality of life. So if you determine it would be good to challenge yourself and try to overcome a fear, I hope the steps outlined above help, and I’d love to hear about any success stories in the comments.