David describes one of the more obscure methods called “Self-Monitoring”. He thinks of it as “Meditation in Daily Life.” The whole idea is to note a negative thought that suddenly pops into your mind, and then to track it, or count it, with some type of counting device, list the wrist counters golfers wear to keep track of their scores, and then to simply let go of the thought and continue with what you were doing, instead of dwelling on the thought and getting distracted and upset.

David explains that Self-Monitoring often is not effective, but occasionally it can be life changing for individuals who are struggling with anxiety, depression, or anger. He brings the method to life with the story of an eye doctor with severe OCD who recovered completely because of Self-Monitoring in combination with Response Prevention.

He also explains how this technique, along with the Daily Mood Log, was curative for a retired carpenter with severe depression following a stroke. The type of stroke is called “Pseudo Bulbar Palsy,” and the symptoms include uncontrollable sobbing or laughing after the slightest sad or funny event or comment.

This case was particularly interesting because the therapist for the carpenter was one of David’s students, a clinical psychologist who had raised the question, “How could cognitive therapy possibly help someone if his or her depression is caused by a chemical imbalance in the brain?” And in this instance, since we know the carpenter’s depression was caused by thousands of microscopic hemorrhages in the deep structures of his brain, how could any kind of psychotherapy possibly help?”