08/24/2010 08:09 am ET | Updated Nov 17, 2011

Cognitive Behavior Therapy for Every Day

I could have let it ruin my day.

It's 1:30 pm, this past Sunday. The first leg of my flight is significantly delayed and now I have to take different flights. Instead of arriving home at midnight, I have to wait at the San Diego airport for 6 1/2 hours, then cross my fingers and hope I'll make my connecting flight, a red-eye from L.A. to Philadelphia that gets in at 6:30 a.m. It's going to be a very long afternoon, evening and night. In fact, it's been a long few days, presenting at the American Psychological Association.

To add insult to injury, I have to wait in the commuter terminal of the airport, which is very crowded, has little reading material for sale and the tiny snack bar has virtually nothing I want to eat. (Well, to be honest, it has lots of junk food I want to eat but I won't let myself. Calories are calories and my metabolic system doesn't care that I'm being highly inconvenienced.)

I am mightily annoyed. And I could have stayed that way. I could have fumed and complained and been in a lousy mood. But, according to the theory behind cognitive behavior therapy, I know that it's not this situation of enforced waiting and the prospect of an uncomfortable night flight that is directly influencing how I feel emotionally; it's how I perceive the situation. Specifically it's the thoughts that are going through my mind that are leading to my feelings of annoyance.

As long as I keep thinking, "This is terrible! I'll be so bored! I'll be exhausted! I won't be able to focus on anything tomorrow. I'll get even more seriously behind work than I already am," I'll feel irritated, perhaps angry. Now I can't stop those thoughts from popping up. They are what we call "automatic thoughts." I'm not deliberately trying to think these thoughts. They just pop up spontaneously. But now that I've identified them, I can do something about them. I don't have to feel so irritated. I can change my thinking.

First I decatastrophize, that is, I recognize that I'm predicting a minor catastrophe and then I reflect on the outcome more realistically. As terrible things go, this really isn't so bad. I'll definitely be tired and it will be hard to concentrate tomorrow. But I will get through the day, as I always do. I remind myself of the period when the kids were babies. I was seriously sleep-deprived then and always managed to function at work. Come to think of it, things could be so much worse. I could be traveling with young, cranky kids.

I also remember how I catastrophized when I was in Kenya four months ago. My return trip through Heathrow was cancelled due to the volcanic ash from Iceland. I had to stay three extra days and I coped. (In fact, I got to see pre-human skulls at the National Museum of Kenya that were 17 MILLION years old. I survived. My patients survived. My staff survived. My work eventually got done. Some delays aren't so bad, after all.)

Thinking in this new way improves my mood--slightly. I say "Oh, well," and stop struggling (see more about this technique in a future blog), which allows me to engage in problem solving. I have six hours to go. I think, "I really should do the work I had planned to do." In particular, I should review the manuscript of my latest book. My heart sinks. (Automatic thoughts: "I don't want to do that. It'll be hard to concentrate in the airport. I deserve a break.") I decide to take the day off. I can always make up the missed work next weekend or stay late at work a few days this week. Already I feel a little better. Instead of working, I'll read the book I brought with me. Plus I have a book on CD to listen to. And I can look for a copy of the Sunday New York Times, a special treat, because I usually have time to read only a few articles online.

All of a sudden, I do a cognitive shift. I realize I have a choice. I can make the worst of the situation (continue bellyaching to myself) or make something better of it. Why not consider this a vacation day? I'm in sunny San Diego. A muscle ache precludes a day of touring but I can find a bench in the sun. I can check my carry on bag, take the bus back to the main terminal and find a restaurant and bookstore. I can call my husband, my kids, my parents, my friends. My mood improves further.

Suddenly I figure out how to make lemonade. I can write about the experience for a blog. That will kill two birds with one stone. Writing will keep me occupied and I'm likely to feel productive (always a good feeling) and I'll be able to cross this task off my list for this week.

Epilogue: It's working. I only have an hour left before I board the plane. I can't say it's been a great day, but it was okay. It definitely wasn't terrible, as I had originally predicted. I finished my book and I enjoyed it. I found decent food. I had a long talk with one of my best friends. Not to mention I've just about finished this blog. Lucky I didn't just buy into my unhelpful thinking. Responding to my unhelpful thoughts allowed me to do problem solving, and I developed a plan that definitely improved the day. The problem didn't go away but my response to the problem changed.

It's lucky I know how to do CBT on myself.